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PRACTICAL VISIONS 

\ ( A Book of Inspiration 

BY 

F. P. MILLARD, D. 0. 

Founder and President of The National League for the Pre- 
vention of Spinal Curvature; Founder and President of 
the International Society for Lymphatic Research; Editor 
of a Quarterly Journal Published by that Society; Ana- 
tomical Artist, Originator of Watermarked Spine in Sta- 
tionery for the Osteopathic Profession; Author of Poliomye- 
litis; Author of Applied Anatomy of The Lymphatics. 



JOURNAL PRINTING COMPANY 
KIRKSVILLE, MISSOURI 






Copyright, 1922 

BY 

F. P. MILLARD 



JMf-9'23 

CH698182 



\*^ 



Dedicated to My Old Friend 

Dr. C. C. Reid 

who first introduced Osteopathy to me 



PREFACE 

Many books have been written along inspirational 
lines. It would be quite impossible to cover new ground, 
so to speak, as there is supposedly " nothing new under 
the sun. " 

The favorite subjects of some of the greatest writers 
and speakers in history have been inspirational in character. 

The title of this book indicates that we intend to dis- 
cuss practical phases. 

In the study of anatomy in our colleges we consider 
the human body along the lines of regional anatomy, sec- 
tional anatomy, surgical anatomy, and so forth. There is 
another phase, of vital importance to all practitioners of 
the therapeutic art, and that is applied anatomy. 

We hear much about visions today. The slogan, 
printed in various magazines, "Where There Is No Vision, 
The People Perish," is pretty well impressed upon the 
minds of the majority of people. We have found that it is 
all well and good to have visions and dreams, and " raise 
our vibrations" to a point where we feel that we are in- 
spired, and can dream dreams that will materialize ; but how 
many of our dreams really come true, and how many can 
we use from a practical standpoint in our everyday prac- 
tice? 

This book is directed to graduates of osteopathic col- 
leges; especially to thoss graduates who have the osteo- 
pathic concept; who have studied osteopathy intending to 
practice it according to the teachings of the great founder, 
Dr. A. T. Still. 

We do not wish, in this book, to consider those who 
have chosen other than osteopathic methods of treating 
the human body. In writing of our experience, which cov- 

—5— 



6 Practical Visions 

ers a period of more than twenty-two years, we mean to 
present things just as we have worked them out in the office 
and as we have written them in the various journals. 

While this book is written for graduates of osteopathy 
who are entering practice, we trust that there will be points 
of interest to those who have been practicing for some years. 
We have also included a few chapter that will be of inter- 
est to those who are students; likewise, a chapter to those 
contemplating the study of osteopathy. 

We do not wish to say anything that is not practical 
in nature, or which cannot be carried out in the office of 
any osteopathic physician, if he is practicing osteopathy 
as taught by Dr. Still. 

We will leave it to others to write on various methods 
in the healing art, outside of the specific lesion idea. We 
consider that this idea is the basic principle in osteopathy, 
and that it will be as long as osteopathy is practiced as a 
scientific method of treating human ailments, according 
to the teachings of the Founder of our Science. 

No man is as great as osteopathy, and no man will 
ever be able to work out all of the principles and practice 
that is included in the osteopathic concept. 

After practicing over twenty-two years, I realize that 
I have just laid the foundation stone for the real work upon 
which to build a greater osteopathic structure, and I hope 
that some day my vision regarding osteopathy, will be 
much greater from a practical standpoint, than it is at the 
present time. 

There always will be among us those who have visions 
greater than our own. Doctor Still had a vision, away back 
in the time when the therapeutic art was confined almost 
entirely to the older school, and we possibly never will ap- 
preciate the great difficulties he encountered in launching a 



Preface 7 

new school, absolutely opposed in every way to the older 
school. Yet he stood firm and never weakened in his great 
effort to present to the world a scientific truth that will 
live throughout the ages. Doctor Still will go down in 
history as the greatest original and forcible thinker ever 
known in therapeutics. 

Osteopathy was given to him in the form of a vision. 
This is a well-known fact, and had it not been of a practical 
nature, it never could have worked out and changed the 
ideas of a thinking world. His vision was practical, from 
a physician's standpoint, or he never could have adapted 
it to the clinic room, bedside, and other places where hu- 
man beings suffer. It has stood the test of time, and count- 
less numbers have been relieved by the therapeutic measures 
he worked out. 

This vision was of such a practical nature that it brought 
conviction in his own mind, and apparently it lingered in 
his mind in the form of an outline that stood before him 
day after day, like a program that requires fulfilling in 
order to be complete and staisfactory. 

A vision of this kind could only be realized and ap- 
preciated by a great mind. Possibly others had part of the 
same vision at different times, but only the great mentality 
of Dr. Still could comprehend the practical vision that was 
given him. Only a man with great force, tremendous con- 
viction, iron will, and undaunted determination, could work 
out a program, under such unusual adversity, carrying his 
ideas forward to a point of satisfactory completion before 
being called Home. 

I dare say that no person ever lived who did not have 
a vision of some kind, either in the way of a dream or an 
impression that, at least, stimulated greater thought and 
activity in some manner. Possibly not a year goes by that 



8 Practical Visions 

we do not have some form of impression, or dream, or vision, 
but of what use are these impressions, or dreams, or visions, 
unless we take hold of them and build upon them a structure 
that will last throughout the ages? 

No two human brains were ever created exactly alike, 
any more than any two faces. No one mind can compre- 
hend everything. No one mind can handle the visions that 
are given to it, in their entirety. A great many of these 
are simply air castles. Apparently, they seem very good, 
but when thoroughly thought over, they seem either im- 
practicable or too great a task to work out. 

Men in this world are selected to do great things, ac- 
cording to the visions that they have. Who could fill the 
place of a president of the United States without having a 
broad vision that includes at least a desire to preside over 
the many states of the Union in a satisfactory manner? 

What man could carry out the work of a great states- 
man, unless he had a practical vision which would lead him 
on to build a structure that would be international in char- 
acter? 

Men are selected for great tasks according to their 
ability, and the visions back of this ability. 

When we want a tunnel put under the Hudson river, 
possibly we find but one man who has sufficient vision to 
carry out the idea. 

When we wish a canal dug across the isthmus, we se- 
lect a man who has a vision sufficiently broad to do that 
work in a satisfactory manner. 

When great dams are to be built, when tunnels are to 
be bored through the mountains, men are selected who have 
visions sufficiently strong to enable them to convince those 
who have charge of the matter that they are capable in 
every respect of carrying out the vision or dream. 



Preface 9 

Thus in all forms of work, in all the various braoches 
of science, music, art, we have men with vision. 

Only a master can produce an oil painting that will 
live through the ages and command respect, attention, and 
a place in a great art salon. 

The greatest generals that ever lived were men who 
had practical visions that enabled them to carry out their 
great schemes and bring success to the armies over which 
they had command. 

We can train our minds to a point where we may re- 
ceive impressions and put them to good use. The majority 
of human beings are timid. They do not appreciate the 
fact that they have, within their skulls, a varying number 
of ounces of cerebral matter, the potentiality of which can 
never be estimated, the capabilities of which will never be 
understood, and the number of superstructures that could 
be built upon the impressions received by which, can never 
be fathomed by the human mind 

No man has ever used all of his brain, or any great 
portion of it, poseibly due to lack of training, possibly from 
illness, or some physical handicap; but, if we only under- 
stood the capabilities of the human mind, and could find 
instructors sufficiently capable to train that mind and bring 
out all of the phases that are so necessary in order to build, 
from impressions and visions, there would be no limit to 
what we might accomplish in every instance. 

F. P. Millard. 
Sept. 4th, 1922. 



CONTENTS 

Chapter Page 

I. Selecting a Life's Work 13 

II. Building the Framework 19 

III. Honoring Your Profession 27 

IV. The Freshman 35 

V. The Sophomore 43 

VI. The Junior .7 53 

VII. The Senior 69 

VIII. Graduation 79 

IX. Opening an Office 87 

X. The Physician Himself 95 

XI. Make a Fresh Diagnosis Every Day 105 

XII. "Not That, But This" 113 

XIII. Alertness 121 

XIV. "Do It Now" 129 

XV. Air Castles 135 

XVI. Getting the Practical Vision 141 

XVII. Specific Treatment 151 

XVIII. Diagnosis .... . 157 

XIX. Be Specific 167 

XX. "Forget It" 177 

XXI. Clinics 185 

XXII. Fees .'. . . . . . . . 193 

XXIII. Letter Writing 203 

XXIV. New Patients , . . . . . 7 . .7 .209 

XXV. TREATMENT ROOM . 7 .217 

XXVI. Advertising 227 

XXVII. Research .7. 235 

XXVIII. Treating Children 243 

XXIX. Office Attendants 251 

XXX. Attitude of a Physician Toward a Patient 263 



CHAPTER I 



SELECTING A LIFE'S 
WORK 



CHAPTER I. 

SELECTING A LIFE'S WORK 

Exactly a quarter of a century ago, Dr. C. C. Reid, now 
one of the best known osteopaths in the world, wrote me, at 
Denver, Colorado, where I had gone to study medicine, 
that I should personally investigate osteopathy at once, 
and that he was at Kirksville, Mo., studying osteopathy 
instead of medicine, as he had formerly planned, and that 
everything was lovely and the goose hung high. 

At that time I was only in my teens, and very keen on 
becoming a physician. I had made up my mind to study 
medicine, to specialize in surgery, and practice surgery the 
rest of my life. 

Somehow or other, the letter seemed so full of inspira- 
tion, and he seemed so deeply convinced that he had found 
the better way of treating human ailments, that the ex- 
pression used in his letter, " everything is lovely and the 
goose hangs high," thrilled me through and through. 

Well do I remember the first osteopathic treatment 
that I ever saw given. Also, I remember well the first pa- 
tient that I ever talked to, who had been cured by oste- 
opathy, after going about on crutches for quite a long time 
and considered incurable. 

Investigation regarding the new science stimulated me 
to such an extent that I realized the absolute truth of the 
statement made by the Old Doctor, that the body is a ma- 
chine, and that if we would make any headway in handling 
diseases we must consider the body from a mechanical 
standpoint and treat accordingly. 

There seemed to be so much logic about osteopathy 
that I could not persuade myself to continue the study of 

—15— 



16 Practical Visions 

medicine. It seemed as if the new school had presented 
something that was tangible, real, scientific, and out of 
which some day the entire world would be benefited directly 
or indirectly, through the teachings of the Founder of this 
new school, called osteopathy. 

Well do I remember the first copies of the Journal of 
Osteopathy, the first osteopathic publication that was ever 
printed; and in my library today I believe I prize the early 
copies of the Journal of Osteopathy more than any other 
osteopathic literature that I have in my possession. There 
seemed to be something about those early journals that 
stimulated and thrilled one to such an extent that he felt 
as if the real truth had been given to the people after all 
these centuries of therapeutic study. 

When a young man decides his course in life, the sub- 
ject that he is going to study, the profession that he has 
chosen; the next thing he thinks about is what particular 
branch or phase of the subject will interest him most, and 
what part of the work seems most practical and most adapted 
to use throughout his career. Every young man wants to 
make the most of life; his great desire is to select some call- 
ing or profession into which he can put his whole soul and 
do his best work. 

It was a shock to me to have to give up my early dreams, 
in which I pictured myself in white robes, operating in some 
hospital in a large city; but, on looking back over the twenty- 
five years since I first started the study of osteopathy, I 
have no regret, and were I to choose my special work again 
along the healing line, I would walk boldly out and enter 
some one of the colleges of osteopathy, and with enthusiasm 
go through the range of subjects and secure all the informa- 
tion that I could; then go out, proud to be called a disciple 
of Dr. A. T. Still. 



Selecting a Life's Work 17 

Strange it is how some one comes into our lives and 
changes our entire program. This is a common occurrence, 
and if we are diverted in the right direction, and the vision 
is a practical one, we follow our work throughout life with 
the greatest of pleasure, and thrill with the thought that 
we have found the work best adapted to our needs and 
temperament. 

I have ever been glad that Dr. C. C. Reid came to my 
assistance at the time when I most needed guidance. 



(2) 



CHAPTER II 



BUILDING THE 
FRAMEWORK 



CHAPTER II. 

BUILDING THE FRAMEWORK 

The thrill of entering college the first day lingers, usual- 
ly, throughout a man's life. Many are the thoughts that 
run through the mind. In the first place, you have chosen 
your calling. In the second place, you feel that you can 
put your whole soul into the work. In the third place, 
your great desire is to build a structure that will last at 
least as long as you live. 

With what eagerness you listen to the first lectures on 
a subject that seems of such vast importance to you as a 
beginner, and later, as you look back, is still of vast im- 
portance, in that it was the foundation of the work upon 
which you accomplished things in later life. 

In every phase of life, a successful man is one who fol- 
lows a schedule; also one who has system, and one who does 
not neglect each day's tasks. This is the secret of a success- 
ful man. 

It is absolutely necessary to lay each stone well, true 
to line, and well cemented, if you wish your structure to last 
for any length of time. 

The majority of students who enter an osteopathic 
college are sincere, and honestly desire to secure all the 
information that can possibly be had, in order that they 
will feel proficient and have confidence when they go out 
into the field to practice. Now this cannot be done unless 
faithful work is daily done, and unless a schedule is followed, 
and no work slighted. 

In every school, almost invariably, the teacher takes 
more interest in those who are anxious to learn, and who 
are keen to know all that there is to be known, as nearly 
as is possible, about the subject that is under discussion. 

—21— 



22 Practical Visions 

The gratification that a student has on examination 
day in knowing that he has written his papers well, is be- 
yond description. He has the satisfaction of knowing that 
he has applied himself during the term; that he has followed 
closely the teachings of the professors; and that he has not 
neglected, in any way, any chapter of the subject. There 
is a satisfaction, at the close of the college career, when one 
receives his diploma and feels within himself that he has 
honestly pursued his studies, and tried in every way to ac- 
quire all of the knowledge that is humanly possible during 
his college course. 

After entering the field, one has that common feeling 
that he has just started in life's great study. If a student 
is at all inclined to be studious, which he should be, he will 
never stop studying, as the longer one practices the healing 
art, the broader the field becomes. There is no such thing 
as being a specialist on every subject in therapeutics. There 
is sufficient study on the central nervous system to con- 
fine a man's research work and clinic work to an entire 
lifetime and then only in a small way will he feel that he is 
master of the situation. 

It is a question whether we ever will know all of the 
reflexes, or understand entirely the autonomic nervous 
system, or, in any way comprehend in its entirety the rela- 
tion between the various nerve centers and the tracts that 
convey messages to all of the organs and parts of the body 
in such perfect harmony and unison through a peculiar co- 
ordination of the central nerve cells that exist in the brain 
and spinal cord. 

But it is quite possible for a student to develop his 
mind to an extent where he will feel that he can diagnose to 
a certain degree the various conditions found in the patient 
under observation. 



Building the Framework 23 

It is also a question whether any known physician at 
the present time, or during the past ages, has ever been able 
to make more than fifty percent of correct diagnoses in 
the average chronic cases. It is practically humanly im- 
possible for a physician to know the condition of the tissues 
within the body throughout its entirety. Objective and 
subjective symptoms portray to us certain existing condi- 
tions, but who knows when a cancer begins, or who knows 
the beginning even of locomotor ataxia? 

The student of today is better fitted than the one of 
yesterday, to comprehend the manifestations of the human 
body, as portrayed in clinical pictures written out by the 
authors of the best text books. 

This need not discourage the student, as we have many 
examples of wonderful physicians, who have conducted 
practices throughout their lives on a very high order; those 
who have written text books; who are specialists; who have 
been benefactors of the human race; and who can picture 
the symptoms, clinically, in a manner that seems almost 
marvelous. 

It is possible for a sincere student so to familiarize 
himself with physiology, applied anatomy, chemistry, and 
all of the various subjects taught in our great colleges today, 
that he will understand the human body sufficiently to give 
relief in the majority of instances. There are certain cases 
that baffle the greatest of physicians. There are certain 
conditions found in certain cases which may, although 
possibly idiosyncrasies, outwit the skill of any human phy- 
sician, and the disease progresses, according to the clinic 
picture, through the various stages, unto an untimely end. 

It is impossible for any physician to handle every form 
of disease. We must, therefore, content ourselves with 
doing the greatest amount of good that we possibly can, 



24 Practical Visions 

and securing the greatest possible knowledge in every phase 
of therapeutics, and leave it to the coming generations to 
point the way to a greater field of diagnosis, in which, possi- 
bly, some day a physician may be able to discern the be- 
ginning of diseases, or prodromal symptoms that are im- 
possible of detection at the present time. A certain stage of 
a disease is usually reached before the physician makes 
the diagnosis, pronouncing the case as one afflicted with 
such and such a trouble. If this were not true, why do 
men under constant care of skilled physicians go down with 
typhoid, or some other disease, and, while apparently in 
perfect health, go through certain stages of a disease that 
may lead to death or chronic conditions that no one dreamed 
of? What physician can say that a certain man will have 
locomotor ataxia, or even paralysis agitans? Or what 
physician would dare say, in all certainty, that a certain 
case would have an embolus that would block the circula- 
tion and put the patient into bed? 

We have no way of telling what will happen to the 
human organism, and no physician can say with sincerity 
that he can cure any trouble; even the scratch of a pin, or an 
ingrown toe nail. Blood poison often overtakes the patient 
when least expected, and sometimes in spite of the greatest 
of skill the patient dies of tetanus. 

It is well for a student to keep in mind that after all, 
no matter how much knowledge he may attain, it is not 
humanly possible, in all instances, to restore his patient, 
even with the greatest of care and skill. There is a certain 
element of uncertainty in any case, and it should serve as a 
hint that no matter what case we have under our care, it 
deserves the very best skill that we can possibly give it. 

Many a case that seems trifling to a surgeon, proves in 
time to be most serious, or even fatal. 



Building the Framework 25 

There is no such thing as a disease or condition being 
trifling in the human body. The greatest skill that we can 
muster, backed up by the greatest amount of study and 
research that we can possibly accomplish, should be centered 
upon every case that comes under our observation. This 
will make a physician successful and appreciated by the 
community in which he practices, more, possibly, than any 
other one point. Sincerity and close attention to each case 
spells success for any physician who has been a student and a 
careful observer of conditions in the human body. 

Every physician should be a research worker, a con- 
stant student, a close observer, and a conscientious worker, 
throughout his life as a practitioner. 



CHAPTER III 



HONORING YOUR 
PROFESSION 



CHAPTER III. 

HONORING YOUR PROFESSION 

When Sir Herbert Barker started out as a bone setter, 
he was not only unrecognized officially, but was referred to 
in a very slighting manner on many occasions. 

Today, the knighting of this wonderful natural worker 
has done more to make members of the art of drugless heal- 
ing proud that they belong to that craft, than anything 
that has happened since Dr. Still's day. 

Years ago we naturally expected, when putting up our 
signs as osteopaths, that we would be referred to often- 
times as "irregulars," " quacks," and even " charlatans" 
and " mountebanks. " In fact, I think I have been called 
all of these, as well as a great many more terms and phrases, 
like "pow-wow doctor," "mesmerizer," "magnetic heal- 
er, " and so forth. 

People become confused regarding the principles of a 
new science or school of healing, and osteopathy, along with 
some of the newer schools, has often been ridiculed in a very 
slighting manner by those who really did not take the pains 
to go into the matter and see for themselves. Many times 
in early days we found it most embarrassing, in doing pioneer 
work, to be almost openly slurred and slighted by the older 
school and its followers. 

About the best thing I ever heard, regarding ethics of 
one of the "irregulars" or "quack doctors," was when one 
of our osteopaths went out into a new field in the early days, 
and, being socially inclined and a good dancer, attended a 
social function, at which two of the old school physicians 
were present. Fortunately, or unfortunately, as the case 
may be, the osteopath was introduced to a medic, and it 

—29— 



30 Pkactical Visions 

happened at a psychological moment, when a great many 
were standing around and listening. When the introduc- 
tion took place, the medic did not know that the person 
to whom he was being introduced was an osteopath, and 
when the osteopath's name was mentioned, as being an 
osteopath, the medic straightened up, cleared his throat, 
and said: "I meet you as a gentleman, but not as a physi- 
cian." The osteopath, being a quick-witted fellow, re- 
plied immediately, "Dr. Small, I meet you as a physician, 
but not as a gentleman." I have never forgotten that 
little episode, and they say that it caused consternation on 
the floor, but that afterward, when the two met, they were 
quite good friends. 

Now, osteopathy is so well known that it is not referred 
to in the same manner as it was in early days, before it 
was known to have the merit that it really possesses. Yet 
even last week we were treating a young girl, who is engaged 
to a druggist. She had torticollis — acute stage — and with 
a specific adjustment, lasting not more than two minutes, 
we were able to give her immediate relief. When she 
reached home, some one asked her regarding her neck and 
how she got rid of her stiff muscle condition so readily. She 
replied that she had just been to the osteopath. The friend 
asked, "Have you gone crazy too?" 

So, we see, even at the present time, some people refer 
to osteopathy as not being quite right, but my point of 
contention is this: any man doing honest work can make 
himself of such service to the community that eventually 
he will be honored by so doing, and people will come to re- 
spect him for his work and the science he represents. We 
should be reasonable enough not to be offended by ill-con- 
sidered remarks on the part of those not acquainted with 
our work. Forge ahead; relieve suffering humanity; carry 



Honoring Your Profession 31 

on free clinics; and make the people realize the real worth 
of osteopathy. If every osteopathic physician will do this, 
we will eventually have the respect of all people. 

Why should not any man feel that he is doing noble 
work when he is straightening the spines of children, re- 
storing withered extremities, taking away headaches, St. 
Vitus' Dance, and all forms of ailments that children have? 
Likewise, why should any one ever feel as if he were not fol- 
lowing a noble science when he is bringing back to health 
those who have been given up by physicians of the older 
school; when each year in our practice we prevent a great 
number of surgical operations and relieve people from suffer- 
ing, who have had chronic ailments for many years? 

Dr. A. T. Still was one of the most persecuted and ridi- 
culed men that has ever lived, pointed to with a finger of 
scorn, indicating softening of the cerebral tissue; but he 
had a great purpose. He had a vision to carry out and 
materialize, and he knew that in time the entire world would 
refer to osteopathy as being the most natural method of 
restoration known in the therapeutic world. 

The whole world loves a good sport. It also likes a 
man who will fight for right to the last ditch. 

A man can make himself great in any position. We 
have noble examples of men who have honored the places 
they occupy, so to speak, and apparently they are kings in 
their own domains. I have known of newsboys who had 
built up such tremendous patronage, and had conducted 
their business so successfully and on such honest lines, that 
they were highly respected as real business men in their 
own cities. We have one in Toronto. I knew of one in 
Denver, who has become quite well-to-do. I remember 
well years ago when he stood on a certain corner, and al- 
though in that city for recuperative purposes, he overcame 



32 Practical Visions 

all obstacles and made himself so honored and respected 
that I have known business men to go two blocks out of 
their way just to buy a paper from him or to speak to him. 

How any osteopath could ever leave his work because 
he felt that some people did not consider him as " regular" 
as the old school physician, I never could understand. If 
such an osteopath would have his mind more on research 
work and the delving into subjects that he might investi- 
gate, along anatomical and physiological lines, he would 
certainly have no chance to reflect upon the trite or small 
sayings of some one who, either iD a jocular or cynical man- 
ner, attempted to ridicule or belittle a science that will last 
through all the ages. 

There is no field more fascinating than that of thera- 
peutics. There are no books more interesting than those 
found on the shelves of a medical library. Any physiology 
is more interesting than the best novel; and books on symp- 
tomatology and diagnosis are more readily appreciated by a 
true student than the best stories by the greatest of de- 
tectives. After all, a physician should be a detective, al- 
ways on the alert for signs, symptoms and tracings. By 
auscultation, one can probe into the mysteries of the hu- 
man body and not only determine the present status, but 
can, through the "process of deduction," almost read the 
life history of his patient. By going over the spinal col- 
umn, the well-posted osteopath can tell you almost the year 
in which a certain accident happened, and almost the man- 
ner in which his patient was twisted or thrown in order to 
produce the certain lesion that has registered itself upon the 
spinal column. From facial lineations, it is very easy for a 
physician to tell almost with accuracy the peculiar organic 
disturbances found within his patient's body; and from the 
nature of the headaches, according to the different areas of 



Honoring Your Profession 33 

the head, it is quite possible in the majority of instances, to 
state whether the headache is from stomach trouble, or pel- 
vic organic disturbances. 

The study of the reflexes alone could easily absorb ten 
years in any osteopath's life, and the careful study of any 
organ will take another ten years, and, in some instances, a 
lifetime. 

As osteopaths, we have access to all books published in 
the world. We have an opportunity to do research work 
to the fullest extent. We must never imagine that every- 
thing has been learned in the way of diagnosis, or treatment, 
or that the last word in technic has been given. Until we 
have solved all physiological and pathological problems con- 
cerning normality and perversion, we should not cease our 
tireless toil, amid inspiring surroundings, which accompany 
eager students trying to solve the mysteries of the human 
body created by the Great Physician, who alone knows the 
significance of cells, tissues and systemic disturbances. 

There are so many phases in the therapeutic world, in 
which students, as all practitioners should be, can delve 
into the mysteries regarding secretions, circulatory dis- 
turbances, nerve instability, hereditary diatheses, along 
with idiosyncrasies, and central lesion manifestations, that 
we have simply to select some one line of work, and follow 
up logically, reasonings that will lead to better diagnoses, 
technic, and treatment. 



(3) 



CHAPTER IV 



THE FRESHMAN 



CHAPTER IV. 

THE FRESHMAN 

Let us again live over our college days and see if we 
can point out wherein we could have made more progress in 
our studies, and accomplished more in the way of connect- 
ing up the various subjects with a consideration of the body 
as a machine, and as a whole. 

The tendency in the first year at college is to get a cir- 
cumscribed idea of the tissues, and neglect, in a way, the 
broader vision that a student really should have in order 
that he may accomplish the greatest amount of work. 

We admit that it is essential to use the microscope in 
histology, biology, and so forth, and that a student must 
secure a definite idea of the basic principles of therapeutics, 
and that the study of cell life is an essential feature for a 
clear understanding of the body as a whole. 

In looking back through the long years, after one has 
been in practice, the subjects in the first year's course seem 
so easy and few in number. It seems as if the student 
should grasp the entire year's course in two or three months' 
time; but we must remember that the studies are new, and 
that possibly the student is working along entirely different 
lines from what he anticipated when he was going through 
high school, and, possibly, college. 

The subject that appeals most to the majority of stu- 
dents is anatomy. The jonah of all subjects, in the majority 
of instances, is chemistry. Lucky is the young man who 
has a liking for chemistry, and who has had particular coach- 
ing along that line. It will lighten his burdens all through 
the four year course, and, after all, chemistry possibly is 
the most important of all subjects in any course that a stu- 

—37— 



38 Practical Visions 

dent may follow. It is necessary to have a good knowledge 
of chemistry in almost every line of work today. Especially 
is it most essential for a student of the human body, who in- 
tends to practice the therapeutic art, to know in detail 
physiological chemistry in order that he may apply his gen- 
eral knowledge to specific cases to the end that his know- 
ledge of chemistry will be of the greatest value to him in 
handling his patients 

There is something fascinating about histology. The 
use of the microscope, acquainting oneself with the various 
forms of cells and tissues, makes the subject anything but 
monotonous from day to day. It is not like the bricks in a 
house. Although they are the units, and the assembling 
of the same make up the whole, yet there is a sameness to 
the bricks and their composition is identical. The fasci- 
nating thing about histology is that each organ has its own 
peculiar function. The position of the cells and arrange- 
ment of the tissues in a state of health is such, that, there 
is a harmonious action of parts composing the various 
organs, or producing the various secretions and activities of 
each cell and tissue. 

After familiarizing oneself with the various cells in the 
human body, and their arrangement in the organs and tis- 
sues, the study of physiology is equally fascinating, in that 
we determine the relative activities of the various organs in 
the systemic functioning of the human machine. 

Few students are capable of making drawings sufficient- 
ly accurate to enable them to derive benefit from their 
rough sketches day after day. However, there are a few 
students who could, with a little practice, acquaint them- 
selves with the art of drawing sufficiently well to enable 
them to grasp more in detail the relation of the cells to the 
tissues, and the tissues to the body as a whole, and thereby 



The Freshman 39 

work out the relationships from time to time and more 
readily understand them through these object lessons. 

We have stated at various times that it is only a mat- 
ter of time until there will be histologies written from a 
different viewpoint, in that the student will be able to grasp 
from drawings and charts the systematic arrangement of 
the various cells and tissues throughout the body almost at 
a glance. It is quite impossible now for a student to get 
his bearings and so arrange in his mind a mental picture of 
the various cells and tissues that he will be able, after finish- 
ing his course in histology, to state exactly the relative pro- 
portions of the different varieties of cells and tissues in the 
general make-up of the human machine. 

We hope at some future date to illustrate a book on 
histology that will make the study a pleasure to any and 
all students. 

Accompanying every illustration that is found in his- 
tologies at the present time, there should be a large chart 
showing the amount of cells and tissues of a certain nature, 
in proportion to that of the entire body. There should be 
drawings and charts also illustrating the various histological 
specimens in their relation to adjacent tissues; also, the 
general vascularization and innervation. This has been 
sadly neglected, and the student only comprehends these 
points after he has well passed through the major part of 
his college course. 

The study of anatomy, as we have stated, is the most 
fascinating. The text books on the subject seem large; the 
words are long and hard; their terminology is sometimes 
difficult to comprehend. It calls for a previous training 
in Latin and Greek. The majority of the words were " coin- 
ed," as we say today, by the ancients. Under varying cir- 
cumstances, each point of interest on the bones was named, 



40 Practical Visions 

either after some physician in the ancient order, or accord- 
ing to the peculiar resemblance to some object other than 
found in the human anatomy. Only in a few instances 
were these original word " coiners" unable to give the par- 
ticular part under discussion a name. In these instances we 
find the word " innominate." This word, however, is pos- 
sibly as significant as some of the terms that are applied 
to the various organs and tissues in different parts of the 
body. 

We found one way of handling the new- word proposi- 
tion most satisfactorily. Were we to go through college 
again, we would follow the same course. 

Securing a two hundred page, indexed, blank book, 
well-bound in cloth, write down every new word in anatomy 
that you come across, right from the first day of college. 
After each word, derivation and significance. The mere 
fact of making out a dictionary of your own is of more value 
than you can possibly imagine. 

Next secure a box of colored crayons, or pencils, and a 
dozen rough, scratch tablets, and continuously design the 
relationship of the various organs and tissues as you pursue 
your course of instruction in anatomy. 

If you can put on paper the relationship of the various 
organs and tissues, you will have an object lesson that will 
imprint itself so readily upon your mind that you will al- 
ways have a much better conception of the part that you 
have designed on paper. 

Some day also there will be anatomies published that 
will be so far ahead of the anatomies that are printed at the 
present time that we will look back to these in wonderment 
and try to determine why the various parts of the body 
were not put up in a manner that would have been more 
readily comprehended by the students in the schools. 



The Fkeshman 41 

We will not give, at this point, our ideas regarding the 
illustrating of an anatomy, but trust some day that we may 
work out in detail, drawings that will make the subject much 
more comprehensible to the student body. 

After the first few months, the freshman begins to think 
that he has the subject of anatomy pretty well in hand. He 
has possibly covered certain sections, or regions, and his 
idea is that if he can cover the rest of the body, he will then 
know the subject very well indeed. We will not try in any 
way to discourage the students, as the subject of anatomy 
is fascinating, and it is possible for the earnest student to 
comprehend anatomy to a great extent; but keep in mind 
that in the first term, when you are going over the various 
sections, one by one, you must some day put them all to- 
gether and so familiarize yourself with the human anatomy 
that you can visualize the entirety of the body mechanism, 
especially in reference to the vascularization and innerva- 
tion of all parts of the body. 

If you are adapted along the line of drawing, try and 
make enlarged pictures, either from your texts, or from 
your biology studies, and you will be surprised at how 
pleasing the results will be. You will feel that you have a 
better understanding of the human organism, both as to 
its localized relationship and from a systemic standpoint. 

Physiology is one of the most fascinating of all the 
subjects. It will pay any student to follow very closely the 
first chapters in any book on physiology. The fundamentals 
of the subject become the basic principles of all functioning 
processes in their relation to the systemic functioning that 
will be considered when one enters the field of practice. 

It is well, also, to buy a blank, bound, volume of good 
paper, and make drawings from time to time, illustrating 
every point that is brought out throughout the book. If 



42 Practical Visions 

you do this, you will find that at the close of the term you 
will have a basic understanding of physiological function- 
ings that will be of great value to you, in that you have 
made objective impressions upon your mind, through the 
various drawings in colors that you have made from time 
to time. 

The subject of embryology is not always so fascinating, 
and yet of vital importance, in that even after you are prac- 
ticing in the field you will find that in discussing organic dis- 
turbances you will constantly be referring back to the em- 
bryological phases, and you will draw some of your finest 
conclusions from your logical, embryological reasonings. 

It is almost impossible to be a good anatomist, or well 
posted in physiology, without absolutely knowing in detail 
your embryology. The peculiar arrangement of the cells, 
tissues and organs of the body as a rule date back to the 
embryological period when the formation of the cells and 
tissues were such that, in some instances, anomolies were 
produced. In other instances, growths, possibly malig- 
nant, eventually may result from a disturbance in the em- 
bryological period. Possibly an existing hereditary dia- 
thesis may produce in time a phase that comes to be patho- 
logical in its significance, and can only be comprehended 
from an embryological standpoint. 

Undoubtedly observations on the part of an expectant 
mother may disturb the unborn to the extent that the, 
mere visualization resulting from an abnormal experience 
either physical or psychological, may disturb the relationship 
of the normal cells so that eventually, almost any known 
disease may result. 

The first term may seem the hardest to the new stu- 
dent; but, in a great many ways, the reasonings from a 
logical and analytical standpoint during the freshman year 
either make or fail to make the true physician in the end. 



CHAPTER V 



THE SOPHOMORE 



CHAPTER V. 

THE SOPHOMORE 

It is with a great sigh of relief that the freshman enters 
his second year. There is something about being a fresh- 
man that makes one feel as if he were nothing at all. How- 
ever, before any structure can be built, there must be a 
foundation, and wise is the student who builds that founda- 
tion well, and builds doubly strong, in case that the struc- 
ture he rears during the four years' course will have stimu- 
lated him sufficiently to add on a few stories later. 

It is the superstructure, built by conscientious research 
work, that makes one doctor more prominent than another. 
We often hear it said, "Well, that Dr. So-and-So was a 
classmate of mine. We studied the same length of time, 
had the same teachers and used the same books. I do not 
see how he is any greater than I am. " That is the wrong 
idea entirely. The viewpoint a freshman gets is often the 
one that will make his fame world-wide, when the man 
standing beside him in the laboratory, and sitting beside 
him in the class-room, will remain just about at the same 
point all through the years as where he left off when he 
finished his course and received his degree. 

There are physicians and surgeons who are sufficiently 
well-known in this country to attract to their clinics other 
surgeons from all the countries in the world, and these same 
leading surgeons went through the same colleges, with the 
same post graduate courses, as a great many others who are 
never heard of. 

If a man devotes his entire time and energy to his work, 
puts his whole soul into it and has a reasonable amount of 



46 Practical Visions 

cerebral matter, there is no reason why he should not excel 
in his work. If he becomes disinterested and does not 
follow up his studies, he passes into class "B" or "C," 
and the world does not hear of him. Be a class "A" man, 
and never stop dreaming and developing the ideas and out- 
lines that are given to you from time to time. No man 
goes through life without a vision. No man lives who has 
not had dreams and been given ideas that, if carried out, 
would make him known the world over. 

The second year's work naturally includes more sub- 
jects than are taught in the first year, and while part of the 
same ground is covered in a more practical manner, yet the 
greater variety of subjects adds particular interest to the 
student who is desirous of having a broader knowledge of 
the fundamental principles of therapeutics. In fact, it 
takes about the first year's work to get the viewpoint 
and to realize just about what is meant by " considering the 
body as a whole," arid learning to classify, co-ordinate, and 
clarify the various subjects. 

It is quite natural for a student in medicine to want to 
learn, as early as possible, how to write a prescription. It 
is equally fascinating for a student in osteopathy to be 
able to give his first treatment. This anxiety upon the part 
of the student is sometimes detrimental, in that it is quite 
necessary to understand the basic principles of a science 
before being able accurately to apply that science when the 
proper time comes. 

Pathology, as taught in the second year, is possibly 
one of the most important subjects that a young physician 
may be instructed in. It is absolutely essential to know 
your pathology in detail, if you expect to make proper diag- 
noses from subjective and objective symptoms. If a physi- 
cian follows closely his pathology text, providing it is cor- 



The Sophomoee 47 

rectly written, and viewed from a standpoint that consid- 
ers the lesion as the factor in determining function or loss of 
the same, the proper application of this subject will enable 
him more accurately to understand and diagnose his pa- 
tient's ailment. 

The second year is too early a time to consider diag- 
nosis or even symptomatology, other than an occasional 
reference on the part of the teacher. 

The first and second years are really the foundation 
work and upon these two years, the third and fourth years' 
structure is built. 

Applied anatomy begins to be woven into the general 
scheme of considering body structure, and well it may be, 
as no subject taught in the four years' course is of more 
practical value than that of applied anatomy. 

There are a number of text books on this subject, and 
we are yet to have more texts written on applied anatomy by 
some of our osteopathic physicians. 

The dissecting room has a fascination for a few, but 
is rather objectionable to a great many; but for the real stu- 
dent and prospective research worker the dissection room 
means but an advancement to a more thorough understand- 
ing of the human body and the mechanical phase which is 
so important to a physician. 

No man can become a well-rounded physician without 
being familiar with all of the tissues and the arrangement of 
the organs in the various regions of the human machine; 
and a thorough comprehension of the body mechanism, as 
demonstrated in the dissecting room, leads the true stu- 
dent to a line of reasoning that will possibly never end, in 
that he has a desire to conduct postmortems later on and 
verify, or be able to contradict, statements made regarding 
diagnosis in antemortem days. 



48 Practical Visions 

A real expert, working in any machine shop, or going 
over a machine that has once been built and perfected, 
must needs know every part of that machine, and not only 
its workings, but the peculiar sounds that are connected 
with the machine when in motion. 

We, likewise, become familiar with the human body 
when diagnosing, by recognizing certain sounds through 
auscultation, palpation, and so forth, that connect up and 
refer back to the days we spent in the dissecting room, figur- 
ing out not only the arrangement of the organs, but their 
relationship to the various structures in the various cavities. 

The study of neurology interests almost every student. 
It is absolutely essential to familiarize yourself with this 
particular branch, in order that you may more thoroughly 
understand what are referred to as impulses, in particular, 
and the effect upon the human mechanism through nerve 
instability, reflected, possibly, by a diseased organ, or cer- 
tain tissues that are abnormal. 

It is not always possible for a teacher instructing day 
by day to determine just which students are most likely to 
become the best practitioners when they enter the field; 
but, as a rule, the professor can tell by the interest shown, 
and by the questions asked, just which students are the 
most promising. However, there are a great many surprises 
in every school, and it often happens that the student of 
whom you expect least turns out to be the best known man. 
Sometimes the dreamy sort of chap, who apparently is not 
listening to what the instructor is saying, and who does not 
always answer with the greatest rapidity the questions fired 
at him, will turn out to be not only a successful practitioner, 
but a research worker. The peculiar formation of the hu- 
man mind is such that a certain turn of the mind, so to 
speak, will bring out ideas not conceived of by other men. 



The Sophomore 49 

The mind is so complex in its workings that should a stu- 
dent be inclined toward an inventive nature, and yet be 
studying therapeutics, he will, in all probability, be the very 
one who will give to the world new ideas regarding the 
functioning of various organs, or possibly something deal- 
ing with the chemistry of the body that has never been 
worked out before. 

As a rule, students in the second year are very anxious 
to do a little treating. They think that " practice makes 
perfect, " and that they should begin to manipulate or to 
adjust certain osseous tissues; and they are very apt to take 
instruction, on the side, from seniors, or possibly, juniors. 
It is better, as a rule, to follow the instruction of the pro- 
fessors, and not hasten into corrective measures until the 
instructor is satisfied that the student is sufficiently ground- 
ed in the basic principles of therapeutics to enable him to 
comprehend and apply with accuracy, such technic as will 
be described from time to time. 

If I were to measure the value of a student, I believe it 
would be along the line of determining how keenly inter- 
ested that student is regarding applied anatomy. This 
would also include applied physiology, if there be such a 
thing. 

At this particular stage in the college course, we usually 
find some of the students putting two and two together and 
wondering just how many nerves there are in the human 
body; how many reflexes, and if it is possible to determine 
new reflexes; also, whether they will discover in pathology 
some new phase, or possibly, in some way, discover a new 
symptom or disease, and, by making the proper applica- 
tion, demonstrate at a later date some technic that will 
reach, through specific nerve centers, certain ailments that 
have practically been neglected in previous years. 

(4) 



50 Practical Visions 

All sorts of ideas go through the student's mind, and, 
strange to say, very few carry out, in after life the dreams 
or wishes they formulated when in the second year. 

During the first year, everything was from an imagina^ 
standpoint, as they had only basic principles or knowledge 
regarding anatomy, physiology, and so forth; but, in the 
second year, after having gone through all of the elementary 
subjects, you will find the students reasoning along a differ- 
ent line, and stating that some day they will do so and so, 
and that, in future years, they will, when they have time, 
write texts on certain subjects, or make a series of dissec- 
tions that will prove so and so. All of this outline work, 
even though imaginary, to some extent, is of value to the 
student, and if he has sufficient will power and determina- 
tion, he will work out some therapeutic truths and visualize 
to the extent that he will be of benefit to his fellow prac- 
titioners. 

During the second year, the study of physiology will 
have become so fascinating that the autonomic system will 
begin to reveal itself, and the student will realize what the 
vasomotors mean, and what certain nerve centers signify, 
relative to the stimulation of the vasomotors controlling 
the blood vessels throughout the body. He will also realize 
that the circulation to the head, for instance, is regulated 
by nerve centers in the region of the upper thoracic; and 
that the impulses must pass through preganglionic fibers 
traversing the first thoracic ganglion, the lower, middle, and 
finally, the superior cervical ganglion, where postganglionic 
fibers are given off to control the vessels in the head. He 
will realize that this arrangement is quite different from that 
found in the control of the mesenteric vessels by the splanch- 
nic nerves, and that the postganglionic arrangement in this 
area is quite different from that in the regulation of the 



The Sophomoke 51 

blood cephalad, as the preganglionic fibers are more or less 
continuous in their arrangement until a portion of the semi- 
lunar ganglion is reached, where the postganglionic fibers 
are given off to control the mesenteric vessels in the abdom- 
inal area. 

He will also have found out that the spinal cord does 
not extend down the full length of the spine, and the reason 
for this peculiar arrangement will have been explained by 
the professor. He will also appreciate the fact that in 
order to control the blood vessels in the lower extremities 
he must consider specific nerve centers in the region of the 
lower thoracic, instead of the lower lumbar and sacral areas, 
although adjustment of the sacrum and innominates may be 
necessary in order to stabilize the spine and secure nerve 
tone sufficiently to re-establish the circulation in the feet. 

Special instruction regarding osteopathic principles 
will have been given in the second year to enable the stu- 
dent to realize the osteopathic concept, as taught by Dr. 
A. T. Still, who worked out in detail the practice of oste- 
opathy, after having made, possibly, more dissections and 
having studied human anatomy more carefully than any 
student that will ever go through an osteopathic college. 



CHAPTER VI 



THE JUNIOR 



CHAPTER VI. 

THE JUNIOR 

The keen and appreciative student at any college of 
osteopathy, who is not extremely handicapped from a finan- 
cial standpoint, will associate himself with some practicing 
physician during the summer months. He may not re- 
ceive any compensation for his services, but there are those 
practicing in the field who are perfectly willing to allow a 
student half way through college, to visit their offices, make 
observations, and possibly talk with them for an hour each 
day or evening. It should be a pleasure for any practitioner 
to extend this courtesy to a student, and if the student is 
sufficiently insistent, and yet ethical, he will have no diffi- 
culty in associating himself, during the summer months, with 
some practitioner. 

Well do I remember the summer months spent under 
one of the older graduates, out in the state of Iowa. Case 
after case came under my observation. The doctor was very 
kind, indeed, to me. She had two offices, and allowed me 
to take charge of one of them, which made me feel that I 
was at least a doctor in the making. The result was that 
after the summer's experience I returned to Kirksville with a 
new vision, a new conception, and a greater determination 
to accomplish more in the last terms than ever before. Need- 
less to say, I was in a better position to ask more intelligent 
questions of the various professors. The result was that the 
last yesbr was of double value to me, and when I was grad- 
uated I felt as if I could go right out, take hold of a practice, 
(which I did) and make good. It gave me confidence and 
an insight into the way in which cases are handled in the 
field. By the way, there is quite a difference in these two 

—55— 



56 Practical Visions 

propositions, as we will discuss in the chapter on "Opening 
an Office." 

We want here to give the student, who is now a junior, 
and referred to as " Doctor " by some of his classmates, an 
insight into the practical viewpoint on various subjects. 
We must admit that in all schools and colleges certain sub- 
jects are included for mental development alone. They have 
no particular practical side, other than developing in the 
mind greater reasoning powers. There are other subjects 
of most vital interest, and on which we do not receive suffi- 
cient instruction. This is no reflection upon the teachers. 
It is quite impossible in a school calendar to arrange sub- 
jects so that one subject will have precedence, or apparently 
greater value, over another subject. It is only after we have 
been handling cases in the field for some years that we can 
tell just what particular part of the course is of the greatest 
value to the student who is anxious to get out in the field 
and make good. " Making good" does not necessarily 
mean accomplishing great things in the way of having a 
tremendous practice. It refers more to specific osteopathy, 
and the results obtained in the shortest period of time. To 
me, the greatest practitioner is the one who can be the most 
specific and at the same time secure the best results. I 
believe this was the Old Doctor's idea when he made that 
famous remark: "Find it, fix it, and leave it alone," which 
should be emblazoned in gold upon the mental vision of 
every student and practitioner in the world. 

We will not indicate specifically what subjects are of 
greatest import in the course, for fear that the students will 
neglect other subjects, but we will emphasize certain phases 
of certain subjects, and no one can be blamed when inferences 
are made by students. 

There is no doubt in the world but that applied anatomy 



The Junior 57 

is of the greatest value, and we regret exceedingly that 
we have not more books on this important subject. Dr. 
M. E. Clark did the osteopathic world great service when 
he published a book on applied anatomy years ago. It 
should have been revised every year since, and the entire 
edition should have been sold out each year. I like those 
doctors who buy the latest editions and do not say that 
because they have a certain book they don't need a revised 
edition. Even anatomies change, and they are still far 
from perfect. We have noted errors in the text and draw- 
ings of the best known anatomy in the world. There is 
one illustration that is incorrect to which attention has 
never been called. A new text on a particular gland in the 
body contains two errors obvious on casual observation, 
and we have not the heart to write the author referring to 
these two errors, for fear he will not appreciate it. 

There will be a splendid revised applied anatomy one 
of these days, and I am not so sure but that there will be 
another applied anatomy, unusually illustrated and contain- 
ing about eleven hundred pages, all from an osteopathic 
standpoint. There is a certain doctor in our profession 
who has been working on this for six years. 

We have suggested in other chapters that the student 
make certain sketches from time to time, even though they 
be crude. These sketches should be made from an applied 
anatomy standpoint, and the field in that line is so vast 
that there is no limitation to it. There is not a single tissue, 
organ, or structure in the human body that cannot be re- 
ferred to from an applied standpoint in almost as many 
ways as the alphabet can be arranged into words that make 
up a dictionary. 

We often think the last word has been said in anatomy, 
as well as in therapeutics, but we will live to see a day when 



58 Practical Visions 

we will look back to the present as the " kindergarten age." 
In time we must know the human mechanism from a stand- 
point that will give us a vision into its workings such that we 
can "put two and two together," so to speak, and size up a 
person not only by his posture, physiological spinal curves, 
unilateral symmetry, thermogenic findings, vasomotor in- 
sufficiencies, vascular irregularities, and lymphatic ede- 
matous areas, but also, putting the various parts together, 
we can make a mental picture from an applied anatomy 
viewpoint, that will enable us to see the entire mechanism 
from a real mechanical standpoint. 

Likewise, we take the various subjects that are studied 
in the third year, and apply them to the clinic room, and the 
bedside. Most of all, we realize as we study each subject 
that when faced by our patients in the field, we must have 
sufficient confidence in our ability to read and interpret the 
various findings, that we will be masters of the situation. 

The subjects included in the junior course are of a na- 
ture that broadens the student almost to the finishing point. 
Possibly some will be more interested in the specialties, and 
surgery will prove fascinating to a number. Eye, ear, nose 
and throat work appeals to a great many, as it is not diffi- 
cult, and the student will feel that he can work a great deal 
in his own private office, surrounded by enamel and nickel 
ware, with a nurse in uniform, and everything in perfect 
readiness at all times. There are still others who will feel 
the call of the Old Doctor, and will long to see what they can 
do in the field by straight osteopathic manipulation. After 
all, osteopathy, in the true sense, as brought out by the Old 
Doctor, referred more to general than to special work. It 
is perfectly all right for those who like specialty work to 
drift off into those fields, and they need not dissociate oste- 
opathy from their specialty, but to my mind those who are 



The Junior 59 

to perpetuate the great science of osteopathy are those who 
will go out and enter into general practice. In other words, 
they will be able to go to the bedside of a fevered patient, 
and by a practical knowledge of human anatomy and by 
specifically applied treatment, from an osteopathic stand- 
point, reduce that fever without even one drop of medica- 
tion. This will bring out self-reliance, confidence, and above 
all, the accumulated knowledge of the nervous mechanism 
from an applied standpoint that we have referred to so many 
times. 

You will also have another test of your ability as a 
physician, when, by non-surgical methods, you will be able 
to prevent operations, restore the human body to normal 
conditions, re-establish internal secretions, and straighten 
out the muscular tangles through correction of osseous 
lesions that interfere so directly with the great nerve forces 
that radiate in all directions from these various specific 
points. 

You will, likewise, be able to attend your obstetrical 
cases and, through osteopathic knowledge, prevent lacera- 
tions and puerperal fevers. Go down to Indianapolis and 
watch that obstetrical wizard who has, possibly, made more 
deliveries than any other osteopath in the world, or go out 
to the Golden Gate Coast and watch that woman who walks 
through the wards in the various hospitals and from an ab- 
solutely osteopathic standpoint, produces a smile on the 
mother's face, instead of a tear and line of worry. 

"Try osteopathy first," is a motto I wish you would 
never get away from — and tell me this: How can an os- 
teopathic physician develop self-reliance, confidence, and 
natural resourcefulness unless he is put to at least an oc- 
casional test? 

It is the dependence upon a little morphia, sedative, 



60 Practical Visions 

anodyne, analgesic, and an occasional operation, at least, 
that makes a physician feel so confident in himself, in that 
he has recourse to certain things that will give relief and not 
bring out the resourceful side or cause him too much worry. 
These are the things that make a physician naturally wonder 
why it is necessary to practice straight osteopathy when he 
can, by various methods, relieve himself of so much worry 
and thinking. 

As we understand it, students come to osteopathic col- 
leges because they are brave, strong, fearless, and feel within 
themselves that they are capable of undertaking tasks that 
can be accomplished very readily if they have the true osteo- 
pathic spirit, and if they are willing sufficiently to educate 
themselves that they will be able to stand the test when the 
crucial time comes. 

After all, how can a man develop if he is not put to a 
crucial test? Why seek the lines of least resistance, when a 
real man should be absolutely fearless and sufficiently inde- 
pendent, as well as courageous, to follow out the course that 
should be given him as demonstrated by the Founder of 
our great Science, osteopathy. 

It is good practice to write an occasional thesis or even 
a few statements regarding the subject under discussion. 
We will close this chapter with a little illustration of what 
a student might write in his junior year, just for a pastime 
in the evening, to satisfy himself that he is sufficiently posted 
on some points in anatomy to write it down. Try this out 
in your various subjects, and learn early to be able to dictate 
to a stenographer. If you are not financially handicapped, 
keep a stenographer busy two or three evenings of the week, 
dictating what you have in your mind, then read it over 
carefully, correcting it, and you will be surprised at how 
much you will learn, and what good training it will be for 



The Junior 61 

you mentally, and how much more readily you will be able 
to think logically, regarding the various propositions that 
confront a physician. 

This outline is not complete, but simply an indication 
of what a junior might write out to test himself as to his 
knowledge on certain subjects. 

Ribs 

Four demi-facets, two synovial sacs, three ligaments, 
three bones and fibrocartilage are necessary to complete a 
typical costovertebral articulation at the costo central 
point of attachment. The head of a rib is ridged, affording 
attachment for the intra-articular ligament that is also fixed 
to the intervertebral substance. This forms a partition 
between the two synovial sacs. The demi-facet on the 
vertebra above forms an articular cavity for the rounded 
surface, or facet, of the upper and inner surface of the head 
of the rib. Likewise the lower vertebral facet receives the 
lower rib surface. This articulation is neatly encompassed 
by a capsular ligament, and further strengthened by a stellate 
ligament. In front of the articulation, a portion of the tho- 
racic autonomic nerve chain is found. We are now referring 
to the typical thoracic vertebrae and not to the exceptions. 

These series of arthrodial joints are of particular inter- 
est to the osteopathic physician. It is hard to conceive of a 
rotated vertebra, or, at least, a mal-aligned one, in the tho- 
racic region that would not involve the costovertebral articu- 
lation. The facets and demi-facets in particular are de- 
pendent for their normal positions upon perfect alignment 
of the spinal column. 

A single lesioned vertebra, if such is possible to any de- 
gree of independent subluxation, disturbs the articular 
costal cavity, formed by facets in two bones apposed only 



62 



Practical Visions 



at their articular surfaces. The attachment of a rib to the 
transverse process of the vertebra containing the lower 
pedicle demi-f acet gives us scope for reasoning out the me- 
chanics involved in an articular cavity composed of parts of 
two edges of closely relationed vertebrae. 

The exact amount of rib movement or deflection pro- 
duced by a subluxated vertebra has not been worked out 
as yet, but research work by McConnell and others has 
demonstrated the disturbance registered within the softer 
tissues by these lesioned vertebrae. 

A few interesting points for students may be worked 
out upon the dog. Carefully watching the effect upon the 
comparative stellate ligaments in subluxating a rib gives 
one an idea of tissue involvements in lesioned areas. 

The tensity of the superior stellate fibers in costal 
rotation in one direction, and the relaxation or corrugation 
of the inferior fibers, or vice versa, demonstrate the amount 
of possible autonomic deflection from a mechanical stand- 
point. 

But we are more interested in the pathological involve- 
ment from a microscopic hemorrhagic standpoint. The 
distorting of the vertebral articular double demi-facet cavity 
by a vertebral subluxation or malpositioned articular rela- 
tionship must occasion microscopical tissue conditions more 
or less perverted in nature. 

The circulation to the region of the facets under dis- 
cussion comes by way of the thoracic inter costals. These 
aortic branches passing back of the thoracic duct, esophagus, 
vena azygos, etc., on the right side, send branches not only 
to follow the costal grooves, but to enter the intervertebral 
foramina, and also the muscles, tissues, etc., around the 
articular surfaces, including the facets we are considering. 

The synovial sacs referred to above, as well as those at 



The Junior 63 

the transverse processes, are dependent upon the circula- 
tion for their membranous secretions. The vasomotor 
nerves controlling the blood vessels are dependent for tone 
upon the nerve tracts communicating with the spinal cord 
segments in the region giving off the white rami, the tho- 
racic almost exclusively. 

The integrity of the spinal column, therefore, must be 
absolute in order that no interference with motor impulses 
or sensory impressions be occasioned. We have yet to 
realize the full significance of the minutest of lesioned areas, 
muscular, ligamentous or osseous. 

The lesioned rib with its disturbance to the sympathetic 
chain may be caused through traumatism or muscular con- 
tracture, and not necessarily involve the vertebral segments 
to any extent, but a lesioned rib, without a vertebral sub- 
luxation, changes the articular cavity for that rib, making 
one-half of the cavity, or one demi-facet, out of line with 
the other half on the adjacent vertebra. 

The internal border of the costotransverse ligament 
bounds an opening through which the posterior branches 
of the intercostal vessels and nerves pass to supply the var- 
ious tissues. 

The rotation of a rib upon its axis may partially close 
this opening, or, at least, bring stress upon these branches. 
The effect may be slight, but may cause disturbance accord- 
ing to the degree of traction and the function of the nerve. 
The vascular interference may produce mild congestion. 
The venous effect will be more marked, because of the more 
ready compressibility of the veins. The nutrition, sensation, 
motion and vasomotor effect in this posterior region nor- 
mally depends upon the lack of pressure along the course of 
these nerve filaments. The tone of these tissues will de- 
pend upon the freedom of the vascular branches. 



64 Practical Visions 

The intercostal arteries and nerves passing in front of 
the costotransverse ligaments, and following the grooves of 
the ribs, are affected in a different manner. The subluxa- 
tion of a rib may itself produce more or less direct inter- 
ference, depending on the amount of costal rotation. The 
rotation of a rib sufficiently marked to disturb the stellate 
ligament, and push forward the sympathetic chain may 
cause organic derangement through the branches of this 
chain going to the viscera. 

There is one more facet in this region not j^et consid- 
ered. The tubercle of each typical rib articulates with a 
facet on the transverse process of the vertebra. Like the 
costovertebral articulation, the capsular ligament at this 
point also encloses a synovial sac; one only at this point, two 
at the vertebral end. 

The anterior, middle and posterior costotransverse 
ligaments make this articulation one with limited motion, 
yet a costal facet for the tubercle allows sufficient movement 
or gliding to accommodate the changed position of the rib 
when lesioned. The peculiar curve of a rib is well known to 
all, and the slightest variation at the head will make a cor- 
respondingly changed position at its tubercle attachment. 
The effect upon all muscles attached to the rib is more or 
less marked, and the pressure upon the vessels and nerve 
at its lower border are likewise interfered with. 

Any costal rotation brings into play, and interferes 
with, all tissues, vessels and nerves in close proximity, and 
every costal subluxation changes at least two intercostal 
spaces. The one is lessened, the other is widened. As in 
vertebral lesions no single vertebra becomes lesioned with- 
out having its effect upon at least two additional vertebrae, 
so no rib can be rotated without disturbing at least two 
other ribs. 



The Junior 65 

Intervertebral Discs 

There are twenty-three intervertebral discs. The 
first vertebra is not cushioned. The shape of the discs 
corresponds with the shape of the bodies of the vertebrae 
in the three regions Their thickness varies with the normal 
spinal curve variations. Collectively, they form almost 
one fourth of the length of the spinal column, below the 
axis. 

Their composition is fibrocartilaginous. Fibrous carti- 
lage is a rare tissue in the human body. The discs contain 
the greatest collective amount. 

The closely woven bundles, or layers, of white fiber 
make up the buffers that absorb shocks in accidents and 
strenuous exercises. 

The softer interior of the discs provides some flexibility 
and the outer interwoven fiber gives strength to the spinal 
column. The spongy substance in the center is least dis- 
turbed in the curvatures, while the outer or denser layers 
resembling tendon tissue become flattened on their edges, 
where curvature produces the greatest amount of pressure. 

While the discs are surrounded by blood vessels, yet 
we find as a rule no vessels, and never any nerves within 
their substance. Cellular fluid sustains their nutriment 
and regulates their growth. 

Early curvature affects both the discs and the bodies 
of the vertebrae. This refers to curvature that has ex- 
isted for a period of time in the spines of growing children. 
In later life the discs alone are disturbed, or distorted, when 
a reasonable scoliosis is present. 

The shape of the discs in the cervical and lumbar regions 
is oval, and in the thoracic, circular. The large lumbar 
discs allow extensive motion in that region. The thickness 
of the discs is not uniform, especially in the cervical and 

(5) 



66 Pkactical Visions 

lumbar regions where their anterior portions are consider- 
ably thicker to preserve the normal curves. In the thoracic 
region we have two additional ligaments attached to each 
disc; the intra-articular, affording attachment to the heads 
of the ribs. 

The smaller thoracic discs, while thinner than in the 
other regions, are better protected and stationed. They 
also help to form the articular cavities for the typical rib 
attachments. 

If the largest discs found in the lumbar region contain 
small synovial cavities as Luschka says, we are reasonably 
sure that small blood vessels penetrate these discs. 

The surfaces of each disc are adherent to the bodies of 
the vertebrae by hyaline cartilages. This is of interest in 
lesioned areas. Just how much rotation or subluxation is 
necessary to disturb their attachments is uncertain, but 
severely lesioned areas must tax the adherent portions. The 
flexibility of the spine is dependent partially upon the discs, 
and to some extent upon the ligaments common to all verte- 
brae. 

The anterior and posterior common ligaments are close- 
ly adherent to the discs, and a lesioned area, if marked, will 
draw heavily upon these ligamentous fibers, as one may 
observe upon lesioning a speciman in situ. 

The integrity of the spinal cord in accident may be 
sustained through perfectly formed discs. The discs not 
only form a portion of the anterior wall of the vertebral 
canal, containing the cord, but serve as preventives to con- 
cussion in accidents. 

The malformation of discs during the developmental 
period endangers the cord in times of traumatism. The 
nutrition of the discs during the growing period, indirect 
as it may be, is an important factor in spinal development. 



The Junior 67 

It is as necessary that the discs be uniformly developed as 
it is that the bodies of the vertebrae be normal. 

Contraction of the musculature in the spinal region 
interferes with the proper development of the discs in youth. 
The thoracic and lumbar branches of the aorta as well as 
those in the cervical region supply the bodies of the verte- 
brae as well as the adjacent muscles and the contents of the 
vertebral canal. Lesioned areas will interfere decidedly 
with the formation of both surfaces of the vertebrae, and 
the intervening discs. Every vertebral body must be de- 
veloped to just such an extent and every disc to a certain 
thickness, in order that the spine as a whole may present all 
of the normal curves. The necessity of thorough spinal 
relaxation in the growing child is obvious. 

In Pott's disease the discs are partially, if not totally, 
destroyed. This makes a lowered resilience within the 
spinal column and necessitates the careful avoidance of trau- 
matic injuries in preventing cord concussion. 

Fortunately, a hunch-back is limited in his activities and 
the cord and nerves are thus protected from severe shock. 

The malformation of the discs in severe scoliosis may 
be overcome to a great extent if the curvature is obliter- 
ated before the period of full development has been reached. 
Nature corrects the distorted discs as well as the slightly 
unevened body surfaces of the vertebrae, if not too late. 

Spinal tone is dependent upon normal vascularization, 
both in the veins and arteries. The correction of all lesions, 
whether osseous or of the softer tissues, is imperative. Os- 
sification in the vertebrae, fortunately, is slower than in 
any other osseous tissue, and we consequently have a greater 
opportunity to do corrective work. 

The discs enter into the formation of the foramina 
through which the vessels, nerves, etc., pass. While the 



68 



Practical Visions 



presence of a vertebral lesion does not necessarily affect the 
size of the foramen, yet the maldevelopment of a disc may 
allow a certain amount of foraminal interference. The 
thinning of a disc, due to malnutrition and adjacent body 
unevenness, allows approximation of the bodies of ad- 
jacent vertebrae, and affects the foramen to a proportionate 
degree. If compressed discs are present the articulation 
suffers readjustment, and the ligaments likewise are either 
hypertensed or over-relaxed. The normality of articulation 
of any two spinal segments depends upon the regularity of 
the formation of the corresponding disc. 

If it were possible for the discs only to become com- 
pressed or malformed, there would be a marked change in 
the axis of the vertebral column. 

The discs make the spine retain its normal curves, yet 
we seldom see a disc altered in shape unless there is a pro- 
portionate vertebral disturbance. 

A normal disc between two normal vertebrae means 
properly toned muscles and ligaments in that particular 
area unless they are contracted or interfered with tempo- 
rarily. The continued presence of contracted muscles will 
tend to compress the discs and disturb the spinal ligaments. 



CHAPTER VII 



THE SENIOR 



CHAPTER VII. 

THE SENIOR 

How far away the freshmen look to a senior! It seems 
like years have passed by since a senior had his first lesson 
in anatomy. He may have known at first only the number 
of bones in the body. He may also have had a short course 
in physiology in high school, and possibly he was sufficiently 
interested, as a young student, to go to the extreme limit of 
learning the names of the twelve cranial nerves. Any young 
man who will learn and remember the names of these nerves 
has a sporting chance of ten to one of becoming a doctor. 
As a rule, the word " pneumogastric, " may be remembered, 
but "hypoglossal" and "spinal accessory" seem a little too 
much to remember, along with the others. 

The senior is in the polishing process. He has covered 
almost every subject, at least the basic ones, and he now 
turns his attention to a grand finale. He has mastered each 
subject sufficiently to prove to the faculty that he is well 
enough posted to receive his degree at the end of the four 
years' course. 

All kinds of ideas and plans surge through his mind. 
A part of the time is taken in dreaming about what he will 
do and where he will locate when he has been graduated. 
He pictures in his mind the establishment of a practice in 
some nice town or city, with a home on the hill, a limousine, 
every convenience, and a small family to start with. He 
also pictures himself as being able to handle a practice with- 
out any particular effort and, on merit, to attract a goodly 
number of patients and have these patients likewise bring 
others. 

—71— 



72 Practical Visions 

You will see seniors in the hallway at the noon hour, 
comparing notes as to the various prospective fields and 
their respective points of interest, and often the graduate 
doctor locates in an entirely different section from what he 
intended when he first entered college. 

Too much time should not be spent in dreaming about 
days to come, as it may interfere with the final year's prog- 
ress sufficiently to make one lose a part, at least, of what he 
really should have in order to be a well-rounded student. 

There are a number of subjects that will be gone over 
in the senior year, that were dealt with from an elementary 
standpoint in previous years. There are also a number 
of new phases that will be of more than casual interest to a 
senior. 

The last year is the most pleasant of all, in that you 
have the basic principles of the various subjects, and you 
have a clearer idea of what the work really should be. Some- 
times it takes almost two years before the real osteopathic 
vision is clearly worked out. I have heard students, after 
being in college for months, say that after a certain lecture 
they really got, for the first time, the true osteopathic con- 
cept. It is quite different now, when osteopathy is better 
known, and teachers have a better way of presenting osteo- 
pathic principles and truths, when so many cases have 
been treated all over the world, and so many good results 
have been obtained, than it was years ago, when we were 
practically groping our way in a new science. 

Anatomy, to a senior, seems comparatively easy. He 
has become familiar with the relationship of the various 
structures. He knows the innervation of all the muscles; 
the articulation of the body is quite familiar. He is also 
well-posted on the ossification of the various bone centers. 
Physiology to him is quite complete, in that he has been 



The Senior 73 

trained to make observations regarding physiological ac- 
tivities in the human system. Pathological phases are 
likewise interesting, as he has been trained from the micro- 
scope to the clinic cases under observation, to discern and 
determine, and to reason from cause to effect, as to the pro- 
gress of the various diseases under consideration. 

He has passed a sufficient number of examinations to 
familiarize himself with the writing of answers to questions 
from a little broader viewpoint. He weaves in a bit of 
physiology, pathology, also symptomatology, in some of 
the answers to questions on anatomy, for instance. While 
he may be over-stepping the bounds to a certain extent, 
yet he feels contented in that he has familiarized himself 
with the subject from every standpoint. 

He is a wise student who will continue to make rough 
sketches or drawings of the various anatomical parts. In 
this way, he will be able to master, to a great extent, the 
sympathetic nervous system. He will become familiar 
with the various ganglia. He will be able to write three or 
four pages on any one of the important ganglia. For in- 
stance, on the superior cervical ganglia, he will make notes 

something like this : 

* * * 

Behind the carotid sheaths and opposite the 2nd and 
3rd cervical vertebrae, lie two ganglia forming the upper- 
most part of the chain we refer to as the autonomic nervous 
system. Through these ganglia pass vasoconstrictor im- 
pulses to the arteries of the head and face. Were it possible 
to visualize the physiological mechanics and workings tak- 
ing place, we would see a flood of impulses, originating in 
the upper thoracic region, passing by way of the anterior 
spinal nerves to and through the first thoracic ganglia, and 
upward through the middle cervical to the superior ganglia. 



74 Practical Visions 

Here the preganglionic fibers terminate, to be extended as 
postganglionic fibers. The many nerve fibers that branch 
from the superior ganglia contain the vasomotor fibers that 
control the vascular tissues found in the head and face. 
These nerve fibers follow the course of the arteries mainly. 
Thus we find the cavernous and carotid plexuses in the 
head, and the pharyngeal plexus in the neck. The position 
of the superior cervical ganglia in relation to the cervical 
vertebrae is of interest from an applied anatomy standpoint. 
We are all familiar with the clinical import of spinal nerve 
interference, but with ganglionic disturbance we have a 
more indirect perversion. 

Cervical subluxations, while causing tissue traction 
upon spinal nerves and vessels, cannot be said to exert a 
direct pressure upon the free ganglia suspended or stretched 
in front of the vertebrae. We must remember, however, 
that all spinal nerves are connected with ganglia of the au- 
tonomic system by gray rami, while the cervical nerves 
give no direct white rami to the cervical ganglia. Thus the 
problem is explained regarding the preganglionic fibers 
to the head passing through the ganglia from the upper 
thoracic, where the first white rami are given off. 

This leads to a second proposition. The first referred 
to cervical lesions affecting the ganglia by way of the gray 
fibers, while this refers to thoracic lesions affecting the su- 
perior cervical ganglia by way of the white rami that con- 
vey the preganglionic fibers. A good example of this is 
the effect upon the ciliary muscles and iris when the nerve 
fibers in the ciliospinal nerve center are interfered with. A 
lesion at the second dorsal may not only affect the ciliary 
muscles, but cause ophthalmic vascular disturbance as well. 

A third interference with the superior cervical ganglia 
may arise from disturbance with the middle cervical ganglia 



The Senior 75 

or even the first thoracic. Any pressure along the course 
of the preganglionic fibers to the superior cervical ganglia 
will result in perversion. 

The superior cervical ganglia give off the superior 
cardiac nerves, which influence the cardiac muscles. Re- 
flexly, cardiovascular disturbance varies arterial tension 
and affects vasomotor control. 

The normal heart, with regular pulse rate within its 
arterial offshoots, allows normal vasomotor control, provid- 
ing no interference with the vasomotor fibers exists. 

The absence of lesions or contracted musculature en- 
sures normal physiological action within the vasomotor 
mechanism. The superior cervical ganglia with their many 
branches, ascending, anterior, etc., if normal, allow perfect 
control of their vasoconstrictor fibers, which are in a state 
of tonic action. The presence of lesions causes immediate 
disturbance proportionate to the amount of interference 
with nerve fibers. 

The normality of physiological impulses depends upon 
the entire absence of lesioned areas in the broadest sense. 

It is a question whether a cervical lesion is of more im- 
portance in regard to a superior cervical ganglionic per- 
version than is an upper thoracic, but we know that the 
simple correction of a cervical lesion will not restore normal 
tone to the superior cervical ganglia if there exist thoracic 
lesions. We might carry the point still further and include 
systemic derangements, but we are confining ourselves as 
closely as possible to direct impingements and local lesions 
as immediate causative factors. 

The communications existing between the superior 
cervical ganglia and certain cranial nerves (5th, 9th, 10th, 
12th) enable us to secure control reflexly of many conditions 
that arise in the head and face. 



76 Practical Visions 

The stimulation of certain cervical nerves and correc- 
tion of cervical lesions influence salivary secretion, tic symp- 
toms, neuralgic phases, glandular tone, etc. The adjust- 
ment of upper thoracic lesioned areas will influence not 
only the eyes but many of the tissues under vasomotor con- 
trol. Epistaxis may be checked at a point as low as the 
second thoracic. 

While it is a disputed point regarding the vasomotor 
supply of various cephalic vessels in the circle of Willis and 
beyond, yet we have proven clinically, at least, that the regu- 
lation of circulation cephalad may be almost perfectly con- 
trolled through the influence of manipulation in the regions 
mentioned. The arrangement of the circle of Willis with 
its double supply of vessels in the protected cervical trans- 
verse processes — the vertebrals — and the free vessels — 
the carotids — in front of the vertebrae and in close relation 
with the superior cervical ganglia, gives us an opportunity 
for regulating the encephalic circulation through the upper 
three or four ganglia. Osseous lesioned areas may disturb 
more or less directly the vertebral arteries, while muscular 
contracted tissues may influence the carotids. 

Besides this more or less direct influence, we still have 
the central vasomotor influence which may be primary or 
secondary. 

The brain centers originating the general vasomotor 
impulses may also be influenced through lesions in the cervical 
or upper dorsal regions. 

Because of the connection of the superior cervical 
ganglia with the 9th and 10th cranial nerves, their function 
is affected according to the amount of lesion disturbance. 
The delicacy of the autonomic system renders it liable to 
variations, and the slightest stimulus may affect the periph- 
eral fibers that are distributed through the head and face. 



The Senior 77 

The superior cervical ganglia control the vast majority 

of cephalic vasomotor impulses and we must not expect 

normal conditions to exist unless we adjust every lesioned 

area, great or small. 

* * * 

A little practice along this line, continued for a few 
years, will enable any student to present a subject in a way 
that will do himself justice. 

How the days drag out! Graduation day seems far 
away at the beginning of the fourth year, and were it not 
for the various new subjects that are taken up in the last 
year, it might become more or less tedious. 

A knowledge of the X-Ray is most satisfying. The 
lectures on medical jurisprudence are always appreciated, 
and differential diagnosis is a most important subject. Diag- 
nosis, in any instance, under any heading, is of great value 
to any student or physician. The lectures on hygiene, pub- 
lic health, diet, are most valuable, but through it all, the 
senior should look forward to a day, not only of graduation, 
but one wherein he will have so acquired the habit of study 
and research that he will feel that it is only the beginning 
for a structure that will be builded upon the outline pre- 
sented in the four years at college. 

The greatest men who have ever practiced therapy of 
any kind, have done their most wonderful work after being 
in the field for some time, or by teaching after having been 
graduated. It takes experience to accomplish new things 
and work out new ideas, along therapeutic lines, and, after 
all, four years preparation in college is but the cornerstone 
of a foundation that should be well builded upon. 



CHAPTER VIII 



GRADUATION 



CHAPTER VIII. 

GRADUATION 

Naturally a student entering college looks forward to 
graduation day with great anticipation. It seems like a 
long hard road when a student enters college and many a 
time during the college course he wonders whether he will 
ever be ready for graduation, and especially when studying 
some of the deeper subjects he feels as if he will never be 
able to pass on those subjects in the final examinations. 

However, a goal is necessary in any race, and when grad- 
uation day comes those who take part are usually over- 
joyed and the feeling of satisfaction when handed a diploma 
is possibly unequalled by any sensation known during the 
college course. 

It does not necessarily mean that the student is a capable 
physician because he has been graduated with honors. 
There are those who pass better in their subjects than any 
one else; there are also those who receive gold medals and 
class honors, but we have noted with great interest that 
some of the best physicians that have ever gone through 
college did not stand particularly high in their classes in 
the way of grade marks. 

Well do I remember a young man from one of the Central 
States, in our class, who did not seem to pay any particular 
attention to the lectures and who never seemed to pass with 
any great credit marks in the final examinations, but this 
same doctor became one of the best known physicians in 
New York City. He seemed to have a natural tendency 
along the line of handling people; his patients have implicit 
confidence in him and he handles some of the most elite in 
that great city. 

—81— 
(6) 



82 Practical Visions 

We cannot always judge as to who will become famous, 
when sitting in the benches at college. We never know what 
a man has in his mind. Also we never know the viewpoint 
or the vision that a young man has when he is listening to 
the lectures from day to day. There is such a thing as 
mental development along unusual lines if certain nerve 
tracts are put into use. Sometimes it is the instructor who 
brings out in certain students a peculiar mental phase that 
means everything to the student, although the professor is 
not aware of what is going on in the mind of one who is 
sitting under him for instruction. 

Physicians, like artists, are born, seldom made. It is a 
peculiar profession and unless a young man is absolutely 
adapted to handling the sick and really has a liking for that 
particular work, it is almost useless for him to study any one 
of the branches of the therapeutic art. 

Years ago I knew of a boy who dissected practically 
everything in the farmyard that he could get his hands on. 
His mother found him one day dissecting a chicken. He 
was sufficiently kind-hearted not to perform vivisection. 
This young man turned out to be one of the great surgeons 
in North America. He absolutely craved surgical work. 
His whole mind and thought were along the one line. 

The older idea was for a parent with three boys to try 
to induce them to become either lawyers, doctors or min- 
isters. Time has reversed the proposition and boys as a 
rule are allowed to choose their own calling. This is most 
fortunate. Even as it is, a great many physicians leave their 
work and go about other duties. 

When old Dr. Still was alive it was his greatest delight 
to attend graduation exercises. Those of us who were 
fortunate enough to go through college when he was still 
the head of it, remember with great pride the time when he 



Graduation 83 

handed us our diplomas, or stood on the platform and in- 
structed the dean or some member of the faculty to hand 
them to us. He usually gave us a few words of good advice 
and usually those words stuck to us for many years. He 
gave us the impression, which was quite correct, that we 
should not expect to have perfect success when first entering 
into practice, and that we would find in a few years 
that we still had something to learn, and that we never 
would learn all there was to be known. At the same 
time he gave us great encouragement and told us that the 
basic principle regarding the management of a practice was 
to have confidence in yourself, and never forget that the 
body is a machine and that the Creator placed within that 
body all of the necessary requirements for perfect physio- 
logical functionings. 

There is something most satisfying about receiving 
a diploma in that you feel that you have won the confidence 
of the faculty as well as those who have control of the insti- 
tution, and you likewise feel that you have something to 
back you up when you open your office. About the first 
thing a young doctor does when fitting up his office is to 
hang his diploma in a conspicuous place where his patients 
and friends can see that he is duly qualified to enter into his 
work with proper backing. 

There is something else about graduation that appeals 
to the one who has completed his course in a satisfactory 
manner, and that is the fact that he has been sufficiently 
studious, and has entertained a proper vision sufficient to 
enable him to comprehend the various teachings that have 
been presented to him from day to day during the college 
course. His mind is carried back by listening to the Class 
President's address, to those days when he first realized the 
significance of the healing art. 



84 Practical Visions 

The first few months, he remembers, were befogged 
by various theories presented in the text books, and it 
took some time for a young man to clarify these in his 
mind, and appreciate the fact that it is possible through 
physiological stimulation or otherwise to control the var- 
ious parts and organs of the human body. It is a happy 
day for a student when he realizes that he has a good idea of 
the great vasomotor system, and knows it is a physiological 
fact that certain nerve centers control the caliber of the 
blood vessels, and also regulate to a greater or less degree the 
functioning of the various organs. Possibly he will recall with 
the greatest of pride the days when pathology became clear 
to him, and that physiology may be turned into pathology 
by a perverted blood stream, therefore appreciating to the 
fullest extent the statement made by Dr. Still that the rule 
of the artery is supreme, and that at the very moment the 
general circulation is interfered with, that moment physi- 
ology becomes pathology. 

Many things will pass through the mind on gradu- 
ated day, but possibly the one that will stand out clearer 
than all others is the fact that when a student is gradu- 
ated he is thrown on his own resources and will be re- 
sponsible for the cases under his direction. There will be 
no professors or clinical advisers to assist you in the field. 
You may have access to fellow practitioners or you may 
be in a small place where you are the only one practicing, 
but the acute feeling experienced by the majority of grad- 
uates is that they are thrown out into the world to battle 
alone. Therefore, a student who has been a close observer, 
who day by day has taken a keen interest in the lectures 
presented to him, and who in the clinic room has observed 
minutely all kinds of symptoms, will feel when he estab- 
lishes a practice of his own that he has had experience 



Graduation 85 

before, and sufficient confidence in his ability to go ahead 
and handle the case or cases that are under his care. 

For some time after graduation the young doctor is 
likely to write back to the school and especially to some one 
professor to whom he has taken a particular fancy, asking 
advice along certain lines. After a graduate is out for a 
few years, he drifts away from this habit and having had a 
great deal of experience through those years, he possibly 
feels that he is in a position to give advice to some of the 
other physicians who have not had equal experience. 
This method of assisting one another is of great value to 
the young practitioners in particular, and, as a rule, they 
appreciate it most highly. 

Graduation is only the beginning of greater things, if 
the student is in reality a student. The doctor who fails 
to remain a student all of his life is the one who will never 
reach any great height, and the doctor who studies the most 
after graduation is the one who received a proper vision when 
going through college in that he realized that college work 
is only frame work arid on that frame work the real struc- 
ture should later on be built. 



CHAPTER IX 



OPENING AN OFFICE 



CHAPTER IX. 

OPENING AN OFFICE 

The majority of graduates want to open their own offices. 
They feel that they can do better practicing alone. There 
are a few, however, who would prefer taking a post-graduate 
course or specializing along some line, or even going in under 
some older practitioner for a year or two. This same idea 
exists in the business world. There are some men who go 
through business college, and receive all the training that 
another man does, yet they feel that they would like to work 
under some one and sometimes this is best. 

The man with initiative and determination to accom- 
plish great things along original lines almost invariably 
paddles his own canoe. We will, therefore, discuss in 
this chapter the physician who launches his barque and 
pushes out and away from shore. 

We welcome the young practitioner. The field is 
great. There never will be too many practitioners in our 
day, although sometimes the undergraduates feel that the 
field is pretty well filled up. This is a great mistake. There 
is greater need at the present time for osteopaths than 
ever before. There are many towns where there is no 
practitioner and there are cities of half a million popula- 
tion where only a score of practitioners try to handle the 
work. 

No line of work is overcrowded so far as high-class 
work is concerned. Not all inventions have yet been made, 
not all poems have yet been written and we have as yet to 
find an artist who will paint on canvas the real colorings 
that nature produces in a sunset. 

—89— 



90 Practical Visions 

No physician as yet has been able to make a complete 
diagnosis in a chronic invalid. The pathological findings 
in an autopsy never quite agree with the diagnosis given 
by the physician when the patient was still alive. No 
known method of diagnosis is as yet complete, and no two 
physicians absolutely coincide in their views and beliefs 
regarding anything from dietetic measures to the real ex- 
isting nerve reflexes that take place in a systemic disturb- 
ance. A practitioner may feel that he has practically diag- 
nosed a case and that he has verified his findings regarding 
specific lesions, and that he has tested all of the reflexes, 
made complete chemical urinalyses and recorded accurately 
various bacterial findings, but what physician living can 
state the absolute condition of certain areas in the ductless 
glands, for instance, without verifying them either by sur- 
gical exploration or later on by an autopsy? 

So we find that there is great room for the young stu- 
dent to spend an hour or two each day in study, going over 
his various text books that he had just left in college and re- 
arranging in his mind comparative propositions, first from a 
physiological standpoint, symptomatological and finally 
pathological. He will begin to realize that the nerve im- 
pulses that were so carefully considered in physiology are 
altered in systemic diseases where pathology reigns supreme. 

We have referred in the previous chapter to the di- 
ploma hanging on the wall. Sometimes this diploma will 
look very fine indeed. Other days when confronted by 
clinic propositions, it will seem as if it meas nothing. 

After practising for almost a quarter of a century, I am 
going to take the liberty of giving a little advice along the 
line of establishing a new practice, and will first deal 
with the selection of an office. 

Before locating in any place, it is well to visit that place 



Opening an Office 91 

and satisfy yourself that you are willing to settle down and 
stay there until you have sufficiently established yourself, 
and won the hearts of the people by administering to them 
as a true physician does. After that you need not worry, 
as you will want to remain. 

As a rule, the best location for an office is not in a resi- 
dence, but in the downtown district. The rents may be a 
little higher, you may feel that you can economize by having 
an office in your house, but it will not be many months before 
you will realize that you have made a mistake, and you will 
feel that you want to move down town where you can be 
within reach of the business men and the shopping throngs. 
There is no doubt in my mind that the difference in rent is 
too minor a proposition even to consider. There are so 
many points of advantage in having an office down town in 
our line of work, that any other proposition should scarcely 
be considered. You should seek an office in a large central 
building. 

It is a mistake for many reasons to have an office in a 
residence. You naturally want to get away from the place 
where you sleep and eat. From a psychological standpoint, 
it is refreshing to go downtown to your office, get your mail, 
handle your patients, make your outside calls and return 
home in the evening refreshed because it is a change. 

There are many other points we might bring out re- 
garding the disadvantage of having an office in your house. 
One that is worth while is that if you are practising in your 
residence, you are not as likely to be on hand to meet pa- 
tients as if you were in an office down town away from 
home environment. There are always a number of 
things to do around a house and especially if you are not 
financially able to have a maid, you are liable to feel 
that you should assist in some of the household duties, and 



92 Practical Visions 

the first thing you know you will be lifting something or 
helping to clean something in the house, and you will appear 
fussed and mussed when you should be concentrating on 
your work. 

There is a thrill about spinning down to the office in the 
morning ready for a day's work, and entering as if you 
were sole proprietor — even if you are pajnng rent — and 
master of the situation in that it depends upon your skill 
and ability to handle successfully the cases that present 
themselves. Have regular office hours and stick to them. 
Get into the habit of going to your office a few minutes 
before it is time to commence your work. When you 
enter your office in the morning go into each of the 
treatment rooms, see that everything is in proper shape even 
though you may have one or more assistants, and even a 
graduate nurse. See for yourself that everything is arranged 
to your liking by going through the rooms before any pa- 
tient enters. You accustom yourself to the room and feel 
when you enter to treat a patient that since you have been 
there before, you are familiar with conditions as they exist 
for that day. 

Some doctors like a central room with a treatment 
table and a number of adjacent dressing rooms. In my own 
mind, I feel that the better arrangement is to have a num- 
ber of treatment rooms, and again psychology enters in 
that going from one room to another I am facing different 
surroundings, and I find it more or less refreshing. Each 
room should invariably have a fan in it for all year round use. 
The corridor as well as private office should likewise have 
fans. The first thing I do in the morning is to start all 
the fans going, opening the windows, and it seems to put life 
into the place. 

Possibly I should have been a mechanic and worked in 



Opening an Office 93 

some great factory where the wheels are eternally buzzing 
during the working hours, but I find that the revolving wheel 
is symbolic of life, or better stated activity, and the first five 
or ten minutes in the morning a physician can tune himself 
for the day's work. You can picture in your mind the 
number of patients that will enter your door that day, the 
manner in which you will handle them, the interest that you 
will take in them and the results that you expect to get in 
each and every case. The results are the fascination of hav- 
ing new patients come in and if you have been practising 
for some time, former patients to drop in and cheer you up 
by telling you how much better they feel. 

Years ago I remember an old doctor saying that the 
greatest pleasure in his life — the happiest moments — were 
those when some former patient would stop him on the 
street and say " Hello, Doc. you did me a world of good 
when I was under your care. I am feeling a thousand per 
cent, better." I have never forgotten the statement that 
old doctor made, and at the time I was not a physician. I 
wondered if the old doctor was sentimental, as it appeared 
to me that there were a great number of things that would 
interest a doctor more than to have a mere statement handed 
to him by some former wreck who had been under his care, 
but as the years go by, I realize that the doctor was right. 
Nothing, absolutely nothing, gives a doctor that peculiar 
thrill except such a statement made by a grateful patient. 

Going back to our office work, the physician should be 
in such good physical trim when his patients enter, that he 
will appeal to them as one who knows a great deal about the 
human body because he himself radiates health and happiness 
and at the same time inspires confidence. You must be in 
perfect trim physically or your patients will observe it. If 
you have a bad cold and a little cough, they will certainly 



94 Practical Visions 

mention it. If your hands are cold they will also mention 
it. You simply must radiate healthful thoughts backed up 
by a good physique if you expect your patients to have full 
confidence in you. 

There was a time when a physician could look wise, 
say little and get away with it, but in this day and age when 
people are constantly reading, in the papers and mag- 
azines, articles that are almost absolutely technical, and 
when various physicians are writing along health lines, and 
discussing various symptoms and diseases from tic 
douloureux to nephritis, we find that they are sufficiently 
posted to make good use of the interrogation point, and 
the physician absolutely must be posted on every line of 
his work, or the patient will lose confidence in him. 

We will not dwell on the personal appearance of a doc- 
tor and refer to his mannerisms or peculiar habits, neither 
will we make any particular reference to the necessity of 
absolute cleanliness and ideas along the line of being well 
dressed and well groomed. No reference will be made to 
the wearing of spotless linen and the need of daily attention 
to the hands in particular, as no physician could go through 
college and not observe these details, but we will state frank- 
ly that there are those who have forgotten these minor 
points, and we have seen doctors wearing soiled linen. We 
have also seen rough hands, digital mourning, and lack of 
tonsorial care. We have often wondered what peculiar 
psychology those physicians harbored when after high school 
and a college course, they were so unthoughtful that they 
could not appreciate the fact that a physician above all 
men should keep himself in a spotless condition. 



CHAPTER X 



THE PHYSICIAN 
HIMSELF 



CHAPTER X. 

THE PHYSICIAN HIMSELF 

Allow me to address you today as I would talk to you 
in my own office if you asked me how I thought a young 
practitioner should prepare himself to handle a heavy prac- 
tice. It is necessary to refer to my own methods in order 
that I may give you an idea of what I have found works 
out satisfactorily in a down town office. 

I have had the experience of conducting a practice in 
my own residence. I have also had the experience of shar- 
ing an office with another doctor, and I am satisfied in my 
own mind that in the majority of cases, the only satisfactory 
method in the long run is to open up the best office possible 
in a large downtown building. 

I may have peculiar ideas as to just how a physi- 
cian should conduct himself and keep himself physically 
fit in order to handle a practice, and while I have made ref- 
erence to handling a large practice, it is not necessary for 
every one to attempt this, and a great many will not want 
to handle too large a practice. However, after years of 
experience, you will possibly feel as I do, that a physician 
who does not handle more practice each year, get better 
results, give shorter treatments and at the same time under- 
stand his patients' conditions more minutely than the year 
previous, is not a progressive physician. 

We will refer in this chapter in particular to the care 
a physician should take in keeping himself physically fit in 
order that he may conduct his practice in a manner satisfac- 
tory both to himself and his patient. Regardless of stature, 
weight, or anything along that line, you will find it a most 

—97— 
(7) 



98 Practical Visions 

serious handicap if you do not have sufficient sleep and rtst 
in order that you may feel keen and alert when you go to 
your office. There are some physicians who feel that in 
order to establish a practice in a new town or city they 
must develop the social side and be well thought of in the 
various clubs, churches, societies, and so forth. This may 
be perfectly proper in many instances, but I have always held 
the opinion that the doctor who is absolutely attending to 
his practice, and while not busy with patients is looking 
over reference books, and posting himself on certain dis- 
eases, is the man who will make the greatest progress in 
handling and developing a practice. Patients like to know 
that their doctor is keeping abreast with the times, that he 
takes all the latest magazines, that he is familiar with the 
latest discoveries along the lines of diagnosis and treat- 
ment and from an osteopathic standpoint the physician 
who is best posted on anatomy, especially applied anatomy, 
is the one who will have the best results. 

There is no getting away from the fact that the work 
of the osteopath is a great deal more strenuous than that 
of the old school physician. We are called upon to give 
out a great deal of strength and energy, and unless we are 
physically fit, or at least keep ourselves in a condition where 
a patient will not take too much out of us, in plain speak- 
ing, we will not be able to handle many cases a day and get 
satisfactory results. Therefore I feel that if an osteopath is 
really desirous of accomplishing great things and really 
wants to have a large practice, he must make preparations 
for handling that practice. 

It may be all right to drive your own car, but do not 
think of changing tires or overhauling your car, or doing 
anything that will in any way take too much energy out of 
you. Reserve your energy for your patients. There will 



The Physician Himself 99 

come certain days when, even though you are strong and 
physically fit, you will feel as if you have to work that 
day almost in a mechanical manner. You may be a bit 
depressed through some news you have received, or possibly 
a letter will disturb you — we are all more or less sensitive 
along certain lines — but by having a reserve amount of 
energy, you will find that you can get through the day very 
nicely, and by a little extra sleep and rest the next day you 
will be perfectly adjusted mentally and physically. 

If you play golf, wear gloves, but do not attend to your 
furnace, carry out ashes or work in the garden . Reserve your 
physical strength and you will make much better headway. 
If driving a car makes you nervous and you reach your 
office in more or less of an agitated manner, you are in no 
condition to handle, for instance, a case of neurasthenia. 
Enter your office in the morning after having a good break- 
fast and if you smoke, a good Havana, feeling that you are 
perfectly capable of handling any number of patients that 
day; also that you are sufficiently clear minded to re- 
member in detail what your patient has told you at a pre- 
vious time, and with that buoyancy of spirit that should 
exist in a physician, take hold of your cases with confidence 
and without talking proceed to make your corrections, and 
make the patient realize that he is receiving the best of 
attention. This does not apply to the first two or three pa- 
tients in the morning, but it applies to the patients that 
come in last in the afternoon. Have sufficient reserved 
energy to give your patient at 4:30 the same thorough spe- 
cific treatment that you did at 9 o'clock in the morning. 

Have your own private office where you can retreat 
occasionally and sit for a few moments collecting your 
thoughts, and feel that you are giving the patient the best 
attention that you possibly can give him. 



100 Practical Visions 

In our chapter on free clinics we will refer to the matter 
of giving these cases the same thorough consideration that 
you do your best paid cases. Always give your patient the 
idea and be sincere about it, that his particular case is the 
star case, and assure him that you are going to bring him 
back to health in the quickest possible manner. This in- 
variably holds good whether the patient is worth fortunes or 
is a clinic case. When people are sick, as a rule, they want 
to get well as quickly as possible, and the more speedy the 
recovery the greater the credit to you. 

If you can make the correction that will bring about 
restoration in one specific treatment, do it, even though the 
patient may be able to take treatment for six months 
without feeling any financial strain. If you can create 
the impression honestly that you are virtually a magician 
at healing, you will find it invaluable because back of it all 
it will mean that you are a good diagnostician, that you 
understand human anatomy, that human nature is an open 
book to you, that you are capable of dealing with new cases 
without hesitation, and with the greatest of confidence. 
You will thus get the reputation of being one who gets 
his cases out in the quickest possible time. 

This will not mean that you are slighting your pa- 
tients in the way of diagnosis, as some may think. It will 
not mean that you are hurrying through with a case end 
giving short treatments, but it will create an impression in 
time that you know your work, and that you are perfectly 
capable of handling your cases in some way or other that 
brings about the best results. 

It is as necessary for a physician to eat, as for any 
other person, and possibly more so, especially in our line of 
work where we have to feel the strain of handling many 
patients. Eat your meals regularly. Let your patients 



The Physician Himself 101 

know that your luncheon hour is at a certain time 
and that you will not see them until you return. 
Needless to say, it is necessary for a physician as well 
as his patient to eat something warm at each meal. 

Likewise office hours are absolutely essential and must 
be respected. If your hours are from nine until five with 
intermission for luncheon, be sure that your last appoint- 
ment is such that you will be through by five o'clock, and do 
not allow yourself, unless in an emergency case, to remain 
in your office after five o'clock. If you do, you will find 
that one half hour after five o'clock will take more out of 
you than the afternoon's work did. Respect your own 
feelings and your patients will act accordingly. After all 
it is a matter not of one day's practice, but day after day. 

There are times in every physician's life when he feels 
as if he would like to exchange with the other man, and 
only by regular office hours and regular eating will it be 
possible for an osteopathic physician to hold up under the 
strain of a large practice and keep physically fit. It is 
possible to do this by regularity. If you will excuse a per- 
sonal reference, I will say that in the last twelve years I have 
been confined to the house but one day, and this was due 
to catching cold by riding in a shower while going to an 
emergency case. It was impossible to seek protection and 
at the same time arrive at the destination where duty called 
me. 

Day after day it is a pleasure to go to the office and 
treat those who come for help and feel at the same time as if 
through regular habits there is sufficient reserved ener- 
gy to enable one to do justice to his patients as they are 
treated one by one. 

There are times in every physician's practice when 
apparently everything seems to go wrong. There are also 



102 Practical Visions 

times when we have a great number of cases on our hands 
that are serious in nature, and there are other times when 
we feel as if we are not getting the results that should 
be expected. The only thing to do in these instances is 
to do our best. It seems like a simple rule but it works, 
and if you continue to give your best service you will find in 
a few days' time that things will clear, your patients' condi- 
tions will change, and with the exception of one or two 
cases, everything will come out lovely. 

I have found it a very good rule to be absolutely frank 
with patients, with very few exceptions, and tell them their 
true condition regardless of what it is, and I have no hesi- 
tancy whatever in not taking a case if I feel that there is 
something about the condition that warrants refusal. We 
cannot expect, even after years of practice, to understand 
every case, and wise is the doctor who states frankly that he 
would rather not take the case for certain reasons. You 
need not give these reasons. You will not be forced to give 
them, but your patient as a rule, will respect your statement 
and compliment you on your frank manner in making the 
statement. 

The physician must be an optimist. He must have the 
disposition to look sufficiently far ahead that he will be 
able to encourage his patient, and justify himself in giving 
the encouragement in that he understands better than the 
patient, the real condition. 

There are some people who believe that weather condi- 
tions have no effect upon them, that they should feel as well 
on a rainy day or before a storm as on a bright sunshiny 
day. Wise is the physician who will handle the situation 
without disturbing to any great extent the patient's reason- 
ings. 

There are also patients who may have psychic neurosis 






The Physician Himself 103 

or may be sufficiently temperamental to be agitated or dis- 
turbed by home environment or business conditions, and 
the all-round physician should likewise be able to handle this 
attitude of mind in a way that will assist the patient to over- 
come his disturbed condition and bring about a restoration 
of health regardless of the type of disease condition that 
may exist. 

We are of the opinion, however, that in no mental case 
of any form from hysteria to dementia praecox will there be 
found an absence of specific osseous lesions. We have never 
as yet seen a case of hysteria for instance, that was not 
backed up by a perverted physiological activity in which 
some pressure or circulatory irregularity existed in some part 
of the human body. From an osteopathic standpoint we 
are supposed to consider a patient not only from a mental 
standpoint in which suggestion and instruction along physio- 
logical lines is sufficient, but we are supposed to examine 
the patient's framework, palpate the various organs and 
determine, if possible, a cause wherein pressure may exist 
in some form or other. People, as a rule, will not complain 
unless there is something to complain about. A perfectly 
well person rarely exists, it is true, and the majority of peo- 
ple have some complaint, but there is most often some hidden 
condition back of the complaint, that may lead to a neurotic 
condition or a disturbed mental state sooner or later. 

In the great institution at Macon, Missouri, as well as 
one or two other similar institutions where for years osteo- 
paths have handled mental cases, we have found out that 
these cases are restored to health after corrective work has 
been done as well as proper suggestion from a therapeutic 
standpoint, and sometimes in the very same cases that were 
not benefited in older institutions where corrective work was 
not a part of the treatment. The physician must be many- 



104 Practical Visions 

sided, and each day will bring up different problems as no two 
cases are exactly the same, and the physician who handles 
a large practice is the one who is best posted on the various 
phases of diagnosis and treatment. Without a doubt, the 
greatest results have been obtained in the majority of in- 
stances by the application of the principles as taught and 
laid down by Dr. A. T. Still, founder of osteopathy. 



CHAPTER XI 



MAKE A FRESH 
DIAGNOSIS EVERY DAY 



CHAPTER XI. 

MAKE A FRESH DIAGNOSIS EVERY DAY 

Walk through a dense forest, stop at some vantage 
point and look through the thickly spaced trees, and you 
will have one viewpoint. Move forward six feet, look in 
apparently the same direction, and you will have another 
viewpoint. 

Ninety-nine per cent is one point higher than ninety- 
eight per cent. Suppose we make a diagnosis one day, and 
we feel justified in saying that we have made an accurate 
diagnosis. The next day we vary our diagnosis slightly, 
according to some new subjective symptom that has pre- 
sented itself, giving us a better insight into the case and 
adding at least one per cent to our total viewpoint. 

It is not a bad idea in some cases to make what we have 
termed for years, a double examination. As a rule new 
cases, that is, chronic cases that come to us for the first time, 
usually select a day in which they feel the best, in order to 
present the best side to the doctor, and give the physician 
the impression that they are able to "come back," so to 
speak, and be restored very readily by his method of treat- 
ment. In order to checkmate this attitude upon the part 
of the patient, we quite often give a second examination be- 
fore attempting to treat the person as a regular patient. 

After the first examination, we select a second day, 
which may be the next day or two weeks hence. If, for 
any reason, the patient does not come on the day that we 
have selected, we surmise at least that he is again choosing 
a day on which he feels the very best. 

It is humanly impossible for any physician of any 
school of therapy to make a one hundred per cent diagnosis 

—107— 



108 Pkactical Visions 

in any case. We may strive to that end, and there are some 
physicians who are very accurate, and who pride themselves 
on being fine diagnosticians, and, undoubtedly, they are 
almost specialists in that line, if such an expression might 
be applied to any physician making accurate diagnoses. 

The X-ray will not reveal the condition of the finer 
tissues and cells, in that at the present stage it is at best 
merely a designator of shadows. We are therefore inclined 
to say that until it is possible to discover some method, if 
ever it can be discovered, that will give us a true insight 
into the physiological and particularly the pathological 
conditions of the tissues in all parts of the body, we will 
remain handicapped. 

Some physicians find it quite difficult to diagnose be- 
tween chicken-pox and small-pox, for instance, and this 
is mostly surface symptom diagnosing. Again, some phy- 
sicians will dispute the cause of acne. Still others fail to 
appreciate the significance of sacs under the eyes. Thus 
we might go down the line of surface symptoms, as we may 
term them, from varicose veins to furuncles, and the man 
who would state absolutely that he is sufficiently posted 
to make an absolute diagnosis in any and all instances, is 
walking on dangerous ground. We thus see that the ex- 
amination of today, also the diagnosis, may not be the same 
as that of tomorrow. We have not the same viewpoint 
any two days. We are supposed to know more each day 
than on the previous day. We are constantly learning 
something about the human body, and the keen, alert phy- 
sician will never stop learning. The mind develops; our 
viewpoint changes, as we classify and re-arrange in our 
minds, certain symptoms that lead up to certain conditions 
that are practically never the same in any two cases. p§ 

In no instance are there two cases absolutely parallel. 



Make a Fresh Diagnosis Every Day 109 

Getting down to a fine point, in no two cases are nerves ever 
affected to the same extent; or sections of the spinal cord 
ever involved in the same degree; or blockage of the circu- 
lation, or lymph flow, ever quite the same. The impulses 
are never the same rate in one person as in another. The 
autonomic reflexes differ according to the condition of the 
nerves, circulation and tissue tone. We may have a typ- 
ical case of Bell's palsy. Yet no two cases have ever been 
absolutely the same in every detail. The final terminals 
of the nerves may be involved to a different degree in one 
instance than in another. The circulation to these nerves 
may be disturbed from a different standpoint. The in- 
stability of the nerve in its relation to the central nervous 
system, as well as its connection with other nerve fibers, 
is never quite the same in any two instances. 

Thus we have, when it comes to diagnosing a case, a 
peculiar proposition, in that the human body is not only a 
machine, but a chemical laboratory, a pulsating collection 
of cells and tissues, controlled by certain nerve centers, 
where instability is realized according to certain principles 
in the way of stimulating forces, circulatory inequalities, 
and so forth. 

No patient is in the same condition one day as on a 
previous day. The chemistry of the body changes. The 
internal secretions vary. The vasomotor tone is not con- 
stant. The reflexes act according to the central nerve con- 
trol with its many indirect actions. The fluids in the body 
are not equalized according to the various regions on various 
occasions. One day there may be mild cephalic congestion. 
Another day, through over-exertion and fatigue, an excess 
of fluid may be found in the region of the ankles; and still 
another day there may be a tendency towards venous stasis 
in the mesenteric area. 



110 Practical Visions 

The tension of the muscles is not the same on any two 
days. We are affected by draughts, exposures, torsions, 
exercises, excitement, dietetic indiscretions, mental de- 
pression, worry, overwork, or one of the many other phases 
that confront the majority of people. 

There is a tendency in the physiological functionings 
of the human body to work in cycles. One day we may be 
depressed, for some practically unknown reason. This 
may be due to an interference with the metabolism of the 
body. Another day we may be exhilarated, also for some 
unknown reason, and express ourselves by saying that we 
never felt better. The next day, also, for some unknown 
reason, we may have an embolus lodge in a cerebral artery 
and produce the symptoms so well known subjectively and 
objectively. Apparently in perfect health one day, the 
next day a patient may come down with typhoid fever, or 
a child may develop mumps, measles, diphtheria, or other 
of the numerous infections. 

Wherein, then, is it possible for a physician to be cer- 
tain at any time, other than to state that along the line of 
general principles certain improvements should take place 
through certain measures, if there are no idiosyncrasies? 

The art of diagnosing, and it is an art if absolutely 
correct, is given to but few men. The majority of physi- 
cians, while they may think they know how to diagnose, 
fail to discern certain symptoms and conditions that are 
existing, from a metabolic standpoint, within the human 
body. 

No physician without making the tests can tell whether 
a patient is immune to vaccine virus or not. Neither can 
a physician tell with accuracy beforehand whether or not a 
certain given dosage will affect that person the same as 
another. We have as yet failed to recognize, previous to 



Make a Fresh Diagnosis Every Day 111 

testing, that peculiar physical condition known as immunity, 
and we have also yet to learn, without making certain tests, 
just how much a person can stand in the way of exercise or 
even manipulation and adjustment, without making the 
tests. 

Thus, we find that we are as yet, after all of these years, 
only in the experimental stage, and that there is sufficient 
room for research work and diagnostic findings to keep our 
physicians busy for many years hence, developing certain 
phases that are yet not understood, by the majority of 
physicians at least. 



CHAPTER XII 



"NOT THAT, BUT THIS 1 



CHAPTER XII. 

"NOT THAT, BUT THIS" 

On our golf links there is a man, fifty years of age, with 
a most commanding manner, with whom it is a pleasure to 
play, for you invariably learn something. His favorite 
expression is "Not that, but this." Should you lose a hole 
to him, he cheers you up by saying, at the next tee, when 
you are recalling your mistakes, "Not that, but this, Doctor," 
and you feel as if you are ready to start life anew. 

Sometimes a single expression will change your view- 
point, and if it is of an optimistic nature, will produce ex- 
hilaration. Suppose we have had a case that has not re- 
sponded as nicely as we would have liked; let us go to the 
next patient saying to ourselves "Not that, but this," and 
determine,, in a most decided manner, to make the greatest 
possible restoration in the least possible time 

Seldom do we see a man who is so full of optimism, 
whose liver and spleen are of sufficient normality to produce 
constant and well-regulated tone in the body; but when we 
do find a man who is bubbling over with energy; who seems 
to live on the hill-tops; it is most refreshing, indeed. 

Walking out of the dining room one day, I met a man 
with his wife and child, a little boy of six. The man was 
about five feet eleven, straight as an arrow, well dressed 
and you could see by his mental attitude that he was a 
constant source of inspiration to the boy, not to mention 
the happy smile on the face of the wife, who seemed to think 
that he was the only man in the world. 

Alertness is one of the great essentials in this life. "Do 
it now" is the greatest single mental stimulant that we know 

—115— 



116 Practical Visions 

of. This book contains chapters on both of these subjects — 
"Alertness" and "Do it Now." 

No man has ever held an important position, who has 
not felt at times that he was not accomplishing as much as 
he possibly might, and there are times in every man's life 
when he feels as if he needs the counsel and cheer of a good 
friend. 

It is quite impossible to be so perfectly fit that we will 
feel each day of the year that we are absolutely capable of 
filling our positions. There are times when everything seems 
to go wrong; there are certain days that are dark days. In 
the financial world and the professional world, there are 
times when things seem almost to reach a crisis, and wise is 
the man who can so steady himself that he will live through 
the crisis and come out from the rapids into the calm, placid 
waters of logical reasoning. 

"Each morning is a new beginning," as Ralph Waldo 
Trine wrote in his famous book years ago, when psychology 
was practically a novelty and when the occult was almost 
uncanny. 

No man can rise in the morning prepared for a great 
day's work, not having made preparation the night before. 
It is well to keep your mental books at night; arrange your 
program for the following day, and on first wakening in the 
morning recall some special event that is to happen that 
day, or some particular piece of work that you have planned 
out that wiJl be for the betterment of humanity. After all, 
we live a life of service. To serve is the greatest thing in 
this world, and that day is lost when at nightfall we have 
not, in some manner or other, influenced for good the life 
of some one person at least. We perhaps had in mind the 
accomplishment of some great piece of work. We may have 
figured on doing some particular research work, and through 



"Not That, But This" 117 

stress of circumstances, peculiar environment, or financial 
stress, felt as if we were subdued and weighted down. No 
man has ever lived who has been absolutely free from grief, 
sorrow, or even pain. Disappointment comes even to those 
who have so fitted themselves in life that others feel that 
they have neither worry nor care. 

In our college days we have possibly dreamed of a time 
when we would have so mastered our subjects that to make 
a diagnosis would be not only easy, but absolutely certain; 
but, strange to say, no two cases have ever been exact dupli- 
cates, and no two sets of symptoms have ever been ex- 
actly the same. The human machine varies, as far as symp- 
toms are concerned, as strikingly as do the faces of any two 
comparative persons. Phrenologists state that no two 
heads have ever measured exactly the same; that no two 
brains have ever weighed exactly the same amount; and the 
mental capacity of no two great personages has ever tallied 
in every respect. We are individuals. We are made up 
of individual cells. Every cell in the living body is an ani- 
mated piece of tissue. The capability of a cell has never 
been understood. The possibilities of tissues depend upon 
the great central nervous system that awakens them to the 
extent that they are not only nourished, but are forced to 
function according to the forces that exist in the body. 

It is well to arrange in our minds early in life the exact 
condition of things ; to realize the potentialities of the human 
organism; the peculiar maneuvering of the human brain; 
the wonderful actions and re-actions of the various nerve 
centers, and the capabilities of the reflexes. Were it possible 
for a man to be in the most perfect tone at any and all times, 
from a physical standpoint, and have a cerebrum that is 
capable of constant and continuous development to the 
extent that each day no derangement would exist, in the 



118 Practical Visions 

way of counter forces, and were it possible for a man to have 
instructions and live in an environment wherein he would 
practically be at school all of his life, under teachers who were 
perfectly capable of instructing from a standpoint that would 
be not only analytical but judicial; we would find the human 
brain would reach a point of development that has never 
been known in the history of man. 

The minute we stop learning, or feel that we have 
nothing to learn from our fellow beings, that moment we 
have mental stasis, if such a thing could exist. The person 
of receptive mind; the good listener; the man who feels that 
he can learn something from every human being with whom 
he comes in contact, is the man who will develop the most. 

There should be no such thing as class rule, sets, or 
castes, but a feeling that each mind is distinctive in itself, 
and that every personage we meet contains in his brain, at 
some point, information that we do not possess. Let the 
other fellow talk. Be a good listener. Say little, unless 
called upon; and keep a mental poise, or balance, that will 
not necessarily reflect wisdom, but that will assure you that 
you are practically master of the situation, in that you are 
sufficiently open-minded to entertain the ideas and thoughts 
of all those who are walking the various paths of life. 

It was never intended that we should agree with every 
person. It is quite as necessary for a variety of beliefs in 
all the various religions, political groups, therapies, and so 
forth, as it is for each individual to have his own peculiar 
characteristics. Let us welcome the situation; appreciate 
it; and arrange ourselves in such a manner that we will de- 
velop and retain individualistic viewpoints. It is a sign of 
lack of initiative to rely upon the judgment of another en- 
tirely. It is also a sign of weakness to be an imitator. 

The brain should be considered a mental laboratory, 



" Not That, But This " 119 

in which we work out various problems each day, and con- 
sidering the brain from that standpoint, it should be a pleas- 
ure to work in this mental laboratory and see how much we 
can accomplish in a year's time. 

Tucked away in the recesses of the brain, as well as in 
the great central nervous mechanism, are records, count- 
less in number; impressions made from the sensitive retina, 
conveyed by the optic nerve and commissures, to areas of 
the brain that have a capacity for holding millions upon 
millions. Registered, also, in the areas of the brain, are 
sounds conveyed by the auditory nerve through that won- 
derful mechanism of the middle and internal ear, that, if 
properly filed and indexed, would fill, in our business meth- 
ods of reasoning, a store house of such great magnitude that 
we could not secure sufficient clerks to do the filing. We 
have, within our cerebral cortex, the most wonderfully con- 
tracted piece of mechanism that was ever created by the 
hand of God. The capabilities of the human brain are be- 
yond all comprehension. Were we to live a thousand years 
and retain our physical vitality, we could not begin to store, 
within this great mental warehouse, the records that could 
be made from day to day. 

To be in perfect physical trim should make the possessor 
of the perfect organism a perfectly contented human being. 
The greatest asset that any man can have is perfect health. 
He does not always realize this, and he is not always cap- 
able of appreciating what perfect health means; but, as a 
working basis, a man with fair mental capacity and perfect 
health should linger long and dwell many years without show- 
ing the signs of old age. 

When you become discouraged and feel as if you had 
lost your game, say to yourself, "Not that, but this!" 



CHAPTER XIII 



ALERTNESS 



CHAPTER XIII. 

ALERTNESS 

Were it possible for me to believe in re-incarnation, and 
could I return again to this mundane sphere, for a change I 
believe I should like to come back as a squirrel. 

For years we have had in our yard, black and gray 
squirrels. They come over from the park, which is only a 
block away. I have often fed these squirrels just to study 
one thing — alertness. Many a time I have watched them 
steal an ear of corn, carry it into the trees, and finally throw 
down the cob after eating away every kernel. It is well 
worth the value of the corn to watch their maneuverings. 

We have always been taught that a cat is about as 
quick as any animal, but in the yard I have many a time 
observed a squirrel teasing a cat, and the utmost helpless- 
ness on the part of the cat in trying to catch the squirrel — 
up and down the tree, on all sides, up on the limbs, dropping 
to the ground, running up another tree, while the cat sat 
watching most intently, waiting for an opportunity to grab 
the squirrel. 

Possibly the position of the squirrel's eyes has some- 
thing to do with its alertness. We know that they have 
mandibles that are beyond all mental comprehension. We 
are familiar with hydraulic power, but the manner in which 
the squirrel twirls a nut, finds a peculiar soft area by dental 
palpation, opens this encrusted capsule containing meat, 
all in a moment's time, leads us to believe that we have 
something yet to learn. 

Now, what application has a squirrel to a human being? 

First of all, we have no school or training in which we 
are taught alertness. We are told, when children, to watch 

—123— 



124 Practical Visions 

out for autos passing, street cars gliding by, and all manner 
of moving vehicles. We are also taught to avoid this thing 
and that, but we are not sufficiently trained in alertness. 
We will stand talking on a street corner, with the wind blow- 
ing on the backs of our necks, when we know full well that 
we will suffer with a cold in two or three days' time. 

We allow our teeth to become more or less decayed, 
and pyorrhea to take possession, when we know that, had 
proper treatment been applied, these various conditions 
might be avoided. 

Unless deterred by a policeman, the majority of people 
will jay- walk across the corners. There seems to be a lack 
of alertness in all of our movements People will slop along 
the street in a manner that makes it almost impossible 
for one who is in a hurry to make any progress; and without 
any warning people will turn at right angles and stop in 
front of a show window, and it is only by exercising the 
greatest of care that one avoids bumping into them. We 
do not believe necessarily in military training, but no one 
has ever instructed us how to move along in public places, 
especially on the busy street, in a manner that will prevent 
irritation on the part of our fellow men. 

There are some people who believe that some particular 
accident will befall them at some time. They know that 
they will end by being killed in some peculiar manner. I 
know of one man who has the slight hallucination that 
possibly one of the greatest dangers to avoid is getting in 
and out of an elevator, and he never steps in or out 
without doing so on the bound. It would be almost im- 
possible to catch him should the elevator slip, as he has 
trained himself to be so alert in that particular maneuver 
that he is sure of clearing himself either way in any instance. 

That is very good training, indeed, but should we de- 



Alertness 125 

velop our alertness in every respect we would find that 
we would accomplish a great deal more, and that we would 
be a great deal safer as far as accidents are concerned. 

Going hack to college days, alertness amounts to en- 
thusiasm. Certain students will sit listening with the great- 
est of eagerness to every word that the professor has to say. 
They will take notes; make references; and in every possible 
manner post themselves on each subject sufficiently to master 
it, as far as that is possible in college days, and come out 
with the best of marks when graduating. 

While this first step is very commendable, it must be 
followed up by alertness in business. The osteopath who 
goes to his office to meet his appointments in a half-hearted 
manner, with cold hands and careless dress, sometimes not 
sufficiently nourished, will lose just that much in his prac- 
tice, as everything works in ratio and proportion in almost 
every instance. I have been treated by osteopaths, who 
were in no physical condition themselves, and upon thor- 
ough investigation, have found that they were not living up 
to a standard, in the way of taking care of themselves, that 
would keep them physically fit, so that their patients would 
feel that they were examples of their work. 

Enthusiasm and alertness are not synonymous, but go 
very well hand in hand, and the man who is absolutely en- 
thusiastic in his work will be more likely to be alert than the 
man who is jogging along from day to day, just putting in 
time. 

It makes the heart glad to see a person so alert that 
when you speak to him he catches everything you say and 
is, apparently, eager for more. We can train ourselves to 
become so alert that we will be interesting to the other 
person, in that we are good listeners. 

From a diagnostic standpoint, we reach the climax of 



126 Practical Visions 

the value of alertness in sizing up our patient, so to speak, 
and noting as rapidly as possible all the various objective 
symptoms, and correlating them in such a manner that 
we feel that we have a good understanding of the patient 
from all standpoints before we have finished our examina- 
tion and given our diagnosis. The manner in which a pa- 
tient walks, talks, listens to what you are saying; the con- 
dition of his skin ; the cold and warm areas over the body; the 
way his feet and hands hang when sitting or walking; the 
way he sits down; the way he gets up; the way he holds his 
head and his chest; all of these little things put together mean 
everything to an observant physician. 

Some doctors think that to make a great impression on 
a patient they must tell him that they don't care to know 
what his symptoms are, or what any one else's opinion is, 
but that they will make their own diagnosis. I am of the 
opinion that it is just as well to listen a little bit to what the 
patient tells you. You need not let on that you are giving 
it any particular weight, but just listen a bit while you are 
working away and making your own examination. You 
may be surprised to find that there are certain things a 
patient knows that you never could find out, even if you are 
psychically inclined, and sometimes a hint or suggestion 
dropped by a patient, whose experience from a subjective 
standpoint has undoubtedly been greater than yours, who 
have observed him simply from an objective standpoint, 
may be most timely and of value to you. It is not neces- 
sary to sit down and let the patient talk to you for ten, fif- 
teen, or twenty minutes, in a roundabout manner, but 
listen in a bit while you are considering the case and add 
that knowledge to your own, and you will be benefited 
thereby. 

There is also a great advantage in being alert along 



Alertness 127 

another line, and that is remembering what the patient 
has told you and what you found at the time of first examina- 
tion. There are many patients who will recall certain 
statements you have made, and who may even remind you 
that you said "so and so." Alertness alone will assist you 
in bringing back from your memory's storehouse these var- 
ious points of interest, which may mean either keeping or 
losing your patient. 

For some reason or other, a physician is supposed to 
be a walking encyclopedia along therapeutical lines. No 
organic disturbance or name given to any particular disease 
is, in the mind of the patient, sufficient reason for his physi- 
cian not being posted on it. They love to quote some term 
that has been given to some disease, possibly of a neighbor, 
or even to their own condition, by some specialist, who has 
made a previous examination, just to see if you understand 
what is meant by that particular diagnosis or terminology. 
The physician who reads various journals, keeps himself 
posted from day to day, and, most of all, studies anatomy 
sufficiently to remember details, is the man who will shine 
in case of an emergency. 

Just the other day I heard a hearty discussion among 
three doctors, regarding an X-ray plate, as to which was the 
radius and which was the ulna. They were all well-posted 
doctors, but in the stress of emergency and excitement, 
with the patient waiting to have the bone set, the discus- 
sion arose as to which bone was broken. Eventually, Gray's 
anatomy was brought out to decide who was correct. 

Alertness in the study of anatomy will associate ideas 
and relationships to such an extent that you will seldom be 
caught in case of an emergency; that you will be able to 
make statements and stand by them, and be found correct 
when the true test is applied. 



128 Peactical Visions 

Alertness will bring to you a good physical condition, 
in that alertness is associated with better vasomotor tone; 
clearer thinking, from a mental standpoint; also better co- 
ordination in the great central nervous mechanism. 






CHAPTER XIV 



"DO IT NOW" 



(9) 



CHAPTER XIV. 

"DO IT NOW" 

Slogans are invaluable. Laconic expressions have 
won battles, when emphasized by the right man. 

The best illustration that I can give of specific osteop- 
athy is that of a good horseman, with tight reins, getting 
the most out of his steed. Whether a horse understands 
psychology or not, I believe there is possibly no more know- 
ing animal than the horse, and about the best test of horse- 
manship is demonstrated when a man or woman takes hold 
of the reins. 

Now, the osteopathic application is this: The confi- 
dence that a doctor has in his own ability, backed up by a 
knowledge of anatomy, physiology, pathology, and so forth, 
is the keynote of his success. Included ic this proposition 
is accurate diagnosis, founded on a knowledge of the basic 
principles of the subjects that we have referred to above. 
A patient knows in an instant whether the physician has a 
clear understanding of his case in his mind, and the mo- 
ment a physician hesitates, or looks puzzled, that moment a 
patient loses his confidence in his physician, just the same 
as a Tiorse will knowingly "act up" or possibly run away 
with the rider who has not sufficient confidence in handling 
or driving. 

Well do I remember when the expression "Do It Now" 
came out in the papers. There are all kinds of applications, 
and perverted ideas may have arisen from this short slogan, 
in that a robber, thug or criminal might make application 
of the motto, but for a man or woman with a sound mind 
and a sound body, I know of no single motto that is of more 
significance. It applies to a physician in his work in every 

—131— 



132 Practical Visions 

phase, except the surgical. Any case that is surgical should 
be considered osteopathically first. 'Try Osteopathy 
First" is a motto we have used for some time. 

In handling clinic cases, where corrections are to be 
made, we do not wait to relax muscles, but immediately 
proceed to make corrections, and the more rapidly we make 
the corrections, the better the results. If there are three or 
four lumbar lesions, or even a lower thoracic, and the child 
has infantile paralysis and withering of one or both legs, we 
at once commence adjustment in these chronic cases, stim- 
ulate the vasomotors, and increase the nerve impulses that 
control the circulation down the limbs. No massage or 
muscle technic will have any particular effect. We must 
hold a tight rein. We must "do it now." "We must get 
results as quickly as possible. The nerve centers that are 
not properly supplied with blood, and drained by veins and 
lymph channels, will sooner or later become so affected that 
they will lose their connection with the great central nervous 
system, that formerly, in normal conditions, held a tight 
rein over them. 

The same proposition holds throughout the entire 
body. The central nervous system controls the reins to ev- 
ery muscle and organ throughout the entire body, and when 
lesions exist, certain nerve centers are cut off, so to speak, 
in that they lack a normal impulse function. We must so 
adjust the human body that the circulation will be restored, 
the nerve cells again resume a normal condition, and the 
afferents and efferents handle the situation as formerly. 

Again, we have a demonstration of a tight rein in the 
vasomotors that control the circulation throughout the en- 
tire body, singly and collectively. There are certain spe- 
cific vasomotor centers; there are also general vasomotor 
centers. It is more like driving horses in tandem, in that 



"Do It Now" 133 

all of the reins must be tense and each horse feel the thrill of 
the tension of the driver who holds the reins in his hands. 
It is this peculiar normal tension throughout the entire body 
that gives tone to the muscles, ligaments and organs, and 
regulates the circulation. Lack of tone, or a loosening of 
the reins, will not only mean vascular disorders, venous sta- 
sis, ptotic conditions, and lymphatic blockage, but there will 
also be a loss of muscle tone and of general nerve tone, 
bringing about lassitude and a chain of symptoms that follow 
a system which has lost its general tone. 

The expression "Do It Now" is a stimulus, and is of 
great value to an osteopath in his treatment rooms. In- 
stead of standing and talking to a patient, take hold of him, 
make your corrections, and let him know that you are there 
for business; that you are anxious for his speedy recovery; 
that you are also anxious to know his subjective symptoms, 
as well as the objective symptoms; that you do not intend 
to leave a stone unturned in bringing about recovery that 
will make him almost equal to what he was before the acci- 
dent, injury, or dietetic error that brought about the func- 
tional and organic disturbances. 

There seems to be so much hesitancy in the world. It 
takes us so long to get down to business. We ask a man 
for an interview; we spend sufficient time in approaching 
the subject to have expressed ourselves in a frank manner 
and received a reply. 

We waste time on the telephone when we should train 
ourselves to express ourselves in a way that would corre- 
spond with records that are made, where each word, sentence 
and paragraph is thoroughly considered before being given 
out for recording. 

"Do It Now" seems to be synonymous with Doctor 
Still's famous expression "Find It, Fix It, and Leave It 



134 Practical Visions 

Alone." There are those who think that Dr. Still was 
possibly too specific, or that he did not intend that his dis- 
ciples should practice his principles and treat in the same 
way that he did, but I am of the opinion that nothing would 
please the Old Doctor more than for each student so thor- 
oughly to have mastered the subject of osteopathy, that 
every diagnosis would be founded upon such a knowledge of 
applied anatomy as comes only through the deepest study 
and research. It was comparatively easy, in the last few 
years, for Dr. A. T. Still to make a diagnosis almost in an 
instant, but remember that back through all the years, he 
spent unnumbered hours working up to a point where the 
body was to him like a machine, all of whose parts were 
thoroughly understood. 

Some of our men are good students; others do not spend 
very much time in a year going over their texts. When 
they once get through college, they feel that the next thing 
in life is to make a living and save up money, or rather, save 
up for those who come along and want them to invest. There 
are few osteopaths who could not have almost everything 
they desire if they would lock the door to speculators and 
agents of all kinds. 

Act on this advice. Do it now and see how it works, 
but be sure that you do it now and get the good out of it. 
It will stimulate your vasomotors, tone your thermogenic 
centers and increase the impulses coming from a nerve with 
unusual functioning branches, possibly more numerous than 
any physician has ever comprehended — the pneumogastric. 
Let us be greater students of applied subjects. "Do It 
Now." 



CHAPTER XV 



AIR CASTLES 



CHAPTER XV. 

AIR CASTLES 

Every year we receive a number of letters from various 
parts of the country, in which confidential matter is dis- 
cussed, usually referring to some "air castle," which, if 
materialized, would be a wonderful proposition. In a ma- 
jority of the instances, I could readily state that they are 
practical, and could be developed to such an extent that 
they would be for the betterment of humanity. 

Almost invariably these well-thought-out schemes and 
mentally conceived "air castles" fail to be erected from a 
substantial standpoint. Whether any idea is lost in this 
world, or whether some one else picks up the same idea, 
in some telepathic way, and carries it on to a perfect con- 
clusion, we are not able to say. But I am strongly of the 
opinion that thoughts create vibrations, that thought waves 
are never lost, and that the more stable the thought, that is, 
the more practical, the better it will carry, in that the vi- 
brations will be more perfect. We have all had experiences 
of a telepathic nature. I have never yet seen a person who 
has not, supposedly at least, influenced the mind of some dis- 
tant friend or relative. These things are common, every 
day, occurrences. But when a man with supposedly sound 
judgment works out a scheme whereby humanity may be 
benefited, and, for some lack of judgment or ripe experience, 
fails to carry out his idea to a conclusive end, we are at a 
loss to know whether it is the fault of the person, or whether 
it is some congenital error, or hereditary diathesis that in- 
terferes with the workings of the great central nervous sys- 
tem that is supposed so to harmonize ideas and thoughts 
that in the perfect correlation and co-ordination there will 

—137— 



138 Practical Visions 

come out a logical reasoning, founded upon a safe and sound 
hypothesis. 

True it is that some minds are of an inventive turn — 
some men are geniuses by birth — but with the great mental 
capacity possessed by every sane man, it boils down to a 
point of concentration and systematic, conclusive, mental 
exercise, whereby a person will follow through, analytically 
and logically, any new thought or line of reasoning that, ap- 
parently at least, has a different turn to it than any express- 
ion that has heretofore been given. 

The same point applies to research work. We have 
referred to students going through college, wherein they 
were absolutely positive that at some future date they 
would do research work along a certain line that would 
startle the world. So confident are they in college even 
at the present time, that the world will be better in a great 
many respects for their having lived, and that therapy will 
have broadened to some extent at least by their research 
findings, that it is almost beyond a question of doubt with 
them; but as they reach a point in their studies where they 
find that the great world of humanity is but a seething mass 
of thoughts, emanating from minds that throw out and 
reflect ideas from almost every conceivable angle, they be- 
come alarmed and wonder if some one else has not thought 
of that same idea before. This throws them off their track, 
and their giving up is absolutely wrong. 

Take up your work, build your "air castles," carry 
them through, even if some one else has done the same 
thing, and nine times out of ten you will find that in the 
process of mental development you will have reached some 
phase or stage in the game that is utterly different from that 
of any other person's reasonings. It is impossible for any 
two human intellects to handle the same ideas and express 
them in absolutely the same manner. 



Air Castles 139 

In order to make a success in any line of work we ab- 
solutely must have enthusiasm. Oftentimes a person is 
accused of being over-exhilarated, or carrying on to the 
extreme, but when it comes down to a fine point, is it not 
true that this same order of enthusiasm carries a thing over 
in almost every instance? 

Osteopathically, we are taught that we should exag- 
gerate the lesion in order to make normal articular restora- 
tion. However true this may be, I find that the man or 
woman who puts his or her whole spirit and energy into any 
particular line of work, as long as it is along the right line, 
is the man or woman who will command attention and ac- 
complish things. 

It is absolutely essential in the advertising line to write 
more or less startling advertisements, in order to attract the 
attention of people. Any ordinary advertisement, or any 
poorly-written advertisement, will never catch the eye of 
the person who rustles through the leaves of a magazine 
today. It has been stated that Gladstone always looked 
through the advertising section of American magazines 
first of all. He intimated that the brains of the country, 
in the line of advertisement writers, had so epitomized 
and summarized in a concentrated form the ideas that 
they wished to put across, that it was a pleasure to read 
their productions. 

One of the best practices a business man could possibly 
have, in the way of mental training along the line of elimina- 
tion of superfluous adjectives and other words, is to spend 
a year or two in the department where telegrams, letter- 
grams, cablegrams, daygrams, and radiograms are issued. 
In a year's time he will find out just what words he can 
leave out without altering to any extent the meaning of a 
sentence or paragraph. 



140 Practical Visions 

The most interesting lectures I ever heard were given 
in Denver twenty -four years ago, by a man who stood on 
the platform in a theater each Sunday morning and talked 
on subjects from a popular standpoint Those who heard 
him agreed that he was the most concise, laconic, and spe- 
cific sentence framer that ever spoke on an American plat- 
form. His lecture on " Books" was a classic, written like a 
telegram — every word eliminated that was not necessary 
in the make-up of the scaffold that held up his great idea. 

Dream your dreams; work out original ideas; but never 
let them drop until you have conclusively demonstrated to 
yourself that you are on either the right or the wrong track, 
and if on the right track, never give up until you have build- 
ed well upon a mental picture; until you have builded well 
upon what was once only a vision or a dream. 



CHAPTER XVI 



GETTING THE 
PRACTICAL VISION 



CHAPTER XVI. 

GETTING THE PRACTICAL VISION 

Some might say that they would not care to live the 
life of an Edison, as he does not accept invitations to ban- 
quets which are given in his honor, and confines himself 
almost entirely to his laboratory, even on his birthdays. 
But we find that in order to accomplish anything great 
in this world we must give our particular work the greatest 
of attention. 

Some one visiting Europe, standing by the tomb of 
Napoleon Bonaparte, paused for a moment and said to a 
friend, "How still he lies!" His mind had been wandering 
back over the history of this great man and his many activi- 
ties; the early hours at which he arose in order to do real 
thinking and strategic planning, and when he summed up 
all of his review of that great and active man, he made the 
remark just quoted. 

Although handicapped physically, there are those 
who have accomplished great things. It is impossible for 
every one to feel as active as the darkey fleeing from a sup- 
posed ghost, and exclaiming when a rabbit started in the 
trail ahead of him, "Get out of my way, so that I can run 
faster." We read so much nowadays about getting the 
vision. There are those who know what vision really is, 
and there are those who will never know. Dr. A. T. Still 
had a vision which was practical in nature and we are profit- 
ing by it. There are millions who go down without ever 
being known. We are all endowed with minds and we 
develop such a small part of our grey matter that the great 
majority of brain cells remain inactive, even when we pass 
away at a goodly age. 

— 143— 



144 Practical Visions 

We find osteopaths who have been practicing a decade, 
and who have never made themselves known in any manner 
outside of their local communities. We also have osteo- 
paths who have been practicing two decades, and who have 
never contributed anything in particular to their science 
and who have never worked out any new ideas in the way of 
developing the greatest science that has ever been discovered 
along therapeutical lines. 

We know of osteopaths who have been practicing twenty 
years or more who are not treating any more patients at the 
present time than they did ten or fifteen years ago, and they 
are giving the same length of treatment, or even longer, 
than they did many years ago. They are still without 
typewriters in their offices; they are still writing longhand 
letters, and very few at that. The same text books that 
they had at school are still on their shelves; no new editions 
have appeared on certain subjects, and very few osteopathic 
books are to be seen. They write no articles for our maga- 
zines; they prepare no papers or addresses for our conven- 
tions; they simply drift along, devoting their entire time to 
their work, and the preparation for a rainy day. They do 
not know what it means to study two or three hours a day, 
on the average; they do not know what it means to do 
research work, or to keep in touch with the various subjects 
common to all schools; they hold no clinics — they are prac- 
tically "dead numbers.' ' 

On the other hand, we have in our profession men who 
go out to practice; men who are full of good ideas; become 
active in the various osteopathic societies; give new thoughts 
and ideas; do research work; improve upon their methods 
of treating, and are of great benefit to the profession as a 
whole in many ways. 

There is no osteopath living who cannot make himself 



Getting the Practical Vision 145 

more or less famous if he will but concentrate on some one 
phase of our work — do research work, and develop certain 
lines of thought — and present it in a way that would be ap- 
preciated and of value to the profession as a whole. 

We are endowed with brains, and we should use them. 
We are going to feel the need of greater activity very short- 
ly; in fact, we are feeling it just now. We are lying down 
on the job to the extent that rival schools, although of low- 
er type, are outnumbering us, in many instances, and unless 
we get the proper vision and become wide awake, we are 
going to find that within a few years we have lost the pear] 
of great price. 

We will consider free clinics for a few minutes, and will 
prove that a free clinic is of greater value to you, in more 
ways than one, than you have ever dreamed of. Since we 
established our clinic six years ago we have been more active 
and have found occasion to do a greater amount of work, 
both in general practice and in contributing along various 
lines to the profession, of articles, drawings and research 
work, than we ever had done before. While we treat as 
many as forty at one clinic meeting, we find that it does not 
take any of our strength, but gives us a thrill and puts us in 
the best condition to carry on our regular work for the re- 
mainder of the day. It is very easy to treat forty clinics 
in one hour and twenty minutes. We can demonstrate at 
any time, and it can be done by others. It is also possible 
to treat as many as eighty-six patients a day, and not be 
too greatly fatigued. 

After all, it is the vision that counts, and the thrill that 
goes with your work. Back of this is a great love for your 
work, based upon most careful and continuous study of the 
human body in all of its various phases. 

We have received from the profession, a few replies to 

(10) 



146 Practical Visions 

letters in which we have asked the doctors to establish clinics, 
with answers along this line: "We have our regular prac- 
tice; it takes all of our time, and we have not sufficient 
strength to conduct clinics as well. ,, Evidently these doctors, 
although endowed with good minds and capable of con- 
ducting good practices, are so self-centered that they are 
devoting their entire time and attention to work that will 
put them in good shape for a rainy day. Why not think of 
the poor unfortunates who have not the mentality that 
these doctors have, who are struggling along, handicapped 
by physical disabilities, and who will possibly never know 
what it is to be in a position where they will be able to 
make more than a bare living? 

To me the greatest pleasure in life is my clinic. I enjoy 
every minute of it, and it is no trouble for me to arise in the 
morning at six, or before, and be in readiness for the clinic, 
which commences about eight o'clock. It is a pleasure, in- 
deed, to see the little ones congregate and look up to us for 
strength and health. It is a thrilling experience, and by the 
time the clinic is over, we feel as if we could conquer the 
whole world. In the first place, we must have love for the 
children and a desire to do them good, and it is possible to 
receive additional strength when we are doing good and when 
we are putting our whole soul into our work. 

Regarding regular practice, it is also the same proposi- 
tion. We must have a vision that is greater than that en- 
tertained by the majority; we must figure out on each morn- 
ing we start our work in a large city that there are at least 
five thousand persons that day who should require our ser- 
vices, and the few we treat are only a small percentage of the 
great number who really need treatment. With this little 
vision in mind, we go about our work joyfully, and treat 
as many as we possibly can, realizing that the majority 



Getting the Practical Vision 147 

of the suffering people can not be handled because there are 
not osteopaths enough. It is a matter of enthusiasm which 
may be included with vision, and no osteopath should go 
into his office in the morning feeling dull or tired. We are 
called upon for greater mental activity than any doctor in 
any other school. We are asked questions that are not 
asked those doctors whose habits are to "look wise and 
keep silent." We are out to educate the world along osteo- 
pathic lines; we are ready to give advice and to answer 
questions. 

In order to prepare oneself for a good day's work, one 
must have a proper amount of sleep, that is, regular sleep. 
If you really want to have a large practice you must do a 
little sacrificing along the lines of pleasure. You must get 
to bed early and keep yourself perfectly fit, so that your 
mind will be active, and that you will remember each pa- 
tient's symptoms, that you will be quick in comprehending 
a patient's trouble, and be ready to give proper diagnosis. 
This calls for extreme mental alertness and physical fitness, 
but all this may be easily acquired if we are more anxious to 
have it than anything else. We may have to forego euchre 
parties, dances, and entertainments of various kinds, as well 
as social functions, but is it not worth it? The few years 
that we are in active practice we should devote our entire 
time and energy to the one thing. So many of our osteo- 
paths think that the social side will be of great advantage 
to them, and we have a few osteopaths who pride themselves 
upon their personality to the extent that they claim they can 
hold a practice from that standpoint better than from that 
of study and research work. 

Now, it is a question as to whether you really want to 
do more work, better work, and have better technic; and 
if you do, we will tell you in a few sentences how to go about 



148 Practical Visions 

it. At least, I am one of the kind who try to practice what 
they preach, and those who have visited me will say that I 
do not make statements which cannot be demonstrated at 
any time or upon any occasion. My wife tells me that 
she has never known or heard of any one who has devoted 
more time, since she has known me, which is twenty-three 
years, than I have in study and research work. Fortunately 
she is of a nature that makes it a pleasure to work, as she is 
perfectly willing to forego the various social stunts in order 
that I may carry out the work which I am trying to do. 
Although studying on the average of three hours almost 
every day in the year, outside of holidays, I find that I am 
still behind in keeping in perfect touch with all of the various 
phases of our work, but I also find that this constant study 
and time put into keeping posted, has been the very thing 
that has made me active in my work and served as a stimulus 
for greater achievement along the line of office work. 

You must go to your office in the morning very fresh; 
you must be ready to give the first patient as much attention 
as the second, and you must also be as fresh at the end of 
the day as you are when you start in the morning. This 
calls for reserve energy and a buoyancy of spirit and a light- 
ness of heart, as our work in a way is depressing unless we 
keep overstocked with strength and energy. We have pur- 
posely kept away from entering into the specialties for the 
reason that we believe that some one must remain active in 
the general practice in each locality, in order that osteopathy 
may be perpetuated. After all, it is the general practitioner 
who is going to perpetuate osteopathy. The specialists 
have entered a field wherein they are not, technically speak- 
ing, looked up to as practitioners of osteopathy. Did you 
ever think of that? While we do not blame them for entering 
the field of specialists for several reasons, we do state that 



Getting the Peactical Vision 149 

osteopathy will be perpetuated almost entirely by those 
who are remaining in general practice. So, you who are 
in general practice are really the standard bearers of oste- 
opathy. 

It will not hurt you to study a little psychology, or to 
read books like those that are published at the present time 
giving one a course along the line of mental training — books 
on Power, Master Keys, and brochures that are printed 
along psychological lines. I have found them a most won- 
derful benefit to me. We must realize that we are human 
dynamos, and that we have energy within us, if properly 
stirred through mental activity, to accomplish almost any- 
thing which we may desire. If we do not feel at the end of 
a year that we are better posted, are better physicians, and 
have better technic, and can handle patients more skillfully, 
than the year previous, we are not accomplishing what we 
should, and we are not living up to the viewpoint we thought 
we had when we talked about vision. An osteopath who 
treats only ten or twelve a day lacks system. He has time 
to burn ; he is not giving himself proper credit. The man who 
treats twenty a day is not doing half what he should do; he 
also has time that he is wasting. The man who treats forty 
a day still has abundance of time. It is all a matter of sys- 
tem, and a matter of knowing how to do things. 

Dr. Reid's course on " Personal Efficiency," I under- 
stand, is great. I enjoy reading his articles and I know of 
many who have been wonderfully benefited by them. Years 
ago he was a partner of mine, when we practiced in Wor- 
cester, Mass., but in those days we did not treat the number 
that we do at the present time, and specialties were practi- 
cally unknown. Allow me to be a bit personal when I an- 
swer a few questions. By the way, I have a very heavy mail, 
and my average correspondence is twenty letters a day. 



150 Practical Visions 

This necessitates, of course, a dictaphone, into which I talk 
in the evenings, after studying for an hour or two. It is a 
very easy matter to talk into a dictaphone and take the 
cylinders to the office in the morning and have them typed 
off by a good stenographer. We have two typewriters, 
Underwoods, and two stenographers all the time. One acts 
as office attendant, and by the way is a graduate nurse. She 
answers certain personal letters, which are handed over to 
her, on her own machine at her desk in the main office. 
So, you see, we are able to write these many letters; also 
dictate technical articles, as well as articles for popular 
magazines, and at least edit one journal on the side, besides 
writing an occasional book, as we have done in the past few 
years, not mentioning the more than three hundred colored 
plates and drawings in black and white which have been 
put out in the last twelve years. 

With those who think it is impossible to treat seventy or 
eighty patients a day, we will not discuss the matter. We 
will simply say we know it is impossible for them to do it 
with their viewpoint and limited vision. We want men in 
our profession who will have still greater vision and who will 
raise the standard of osteopathy, both as to technic and as 
to details and research work, and bring our profession to the 
forefront as it has never been brought before. 



CHAPTER XVII 



SPECIFIC TREATMENT 



CHAPTER XVII. 

SPECIFIC TREATMENT 

Some years ago I heard Sir William Osier lecture on a 
medical subject, and he referred to the amount of medicine 
given by the young medical practitioner, just commencing 
practice, and showed how each year the dosage was lessened, 
until after a physician had practiced medicine for twenty 
years or more, he was ready to state that there were few 
known specifics and that a sufficient quantity of medicine 
for a large practice could be carried in his vest pocket. 
While he did not name the four specifics, the majority of 
people know what they are. 

Now, specific osteopathy is an entirely different propo- 
sition, in that we do not eradicate, as years go by, the spe- 
cial treatment given to certain nerve centers; but we do 
treat more specifically, and we don't spend the great length 
of time in making our findings and in trying to relieve all 
symptoms at once, as the young practitioner is most liable 
to do. 

It takes time to familiarize oneself with the human 
anatomy and give specific treatment, and we do not blame 
the young practitioner the first year for giving fairly long 
treatment; but when a man practices for ten years, or even 
five years, and still gives half hour treatments, just then we 
put that practitioner down as one who is not progressing, 
and one who is not familiarizing himself with the specific 
nerve centers that control the various organs and tissues 
in the human body. 

Just wherein does specific treatment differ from general 
treatment? It is true that we treat the same nerve centers 
in specific treatment as we do in general treatment, but we 

— 153— 



154 Practical Visions 

don't go over and over these same nerve centers, relaxing 
muscles and teasing out the tissue contractures, but we 
apply sufficient force to get articular motion in a manner 
that gives, at the same time, vasomotor stimulation. 

In order to make this perfectly clear, we will give a few 
examples and show wherein a specific treatment is of more 
value to a patient than a general treatment, and wherein 
we can make better headway by giving specific treatment 
and restore the patient in a shorter period of time. 

We will take, for instance, a case of migraine, so com- 
monly found, and so noticeably presented, as a rule, to a 
young physician. He is of the opinion that it can be cured 
at once. He gives a thorough cervical treatment, as well 
as general treatment, and he is so positive that the migraine 
condition will pass away that he is very much surprised 
to find, in some instances, that it is a reflex disturbance, 
and that a general systemic harmony must exist before it is 
relieved. It may be necessary to reduce an acidosis, pos- 
sibly from an innominate lesion. There may be flat feet, 
changing the axis of the spine. The pneumogastric with 
its various ramifications may be involved. There may be 
hepatic congestion or splenic enlargement; renal or supra- 
renal disturbance, and last, but not least, an ovarian colic 
accompanying the migraine, or a pelvic congestion involving 
not only the various organs and tissues, but the lymphatic 
nodes, in their relation to the mesenteric vessels. 

The young physician will possibly visualize a patient's 
condition from a general standpoint, focusing his attention 
on the cervical lesion in order to relieve the disturbance 
higher up. He may or he may not realize that the great 
vasomotor and splanchnic centers are involved, in that the 
upper thoracic, or even middle thoracic, lesions may be 
the causative factor, through the semilunar ganglion, or 
there may be a reflected disturbance in the hypogastric 



Specific Treatment 155 

plexus or pelvic plexus, through a tilted sacrum or an an- 
terior lumbar condition. 

Take another case. There may simply be neuritis 
in the shoulders or down the arm. Only a careful observer, 
who has been trained along the lines of lymphatic terminal 
drainage, would notice that peculiar edematouus condition 
back of the clavicles, at the sternal end, and realize that the 
neuritis may possibly be due primarily to a specific verte- 
bral lesion, and, secondarily, to lymphatic blockage that 
exists even in the spaces around the nerve cells. It is only 
of recent date that we have found, through research work, 
that there may be a lymphatic blockage within the sheath 
of a nerve, and that until restoration is made, in the way 
of lymphatic drainage, it will be quite impossible to reduce 
the neuritic condition. 

A third illustration. There may be a swollen or ede- 
matous condition of the ankles. This may not appear to 
the patient as being of any significance. The young doctor 
may feel that it is simply a lack of drainage, that there may 
be a little enteroptosis, or possibly a pelvic congestion; and 
he may not connect up the fact that the edematous area 
corresponds with the blockage in the popliteal spaces, as 
well as the inguinal nodes, and that the lymph channels 
may be blocked to such an extent that the receptaculum 
chyli is overloaded. There may also be a secondary con- 
dition, from the fact that the hepatic nodes, as well as the 
gastric and splenic, are likewise enlarged, and that the entire 
lymphatic drainage system is blocked in the region of the 
diaphragm. 

Correcting the vertebral lesions will be of no particular 
permanent value if there is a sacral tilt, or if one of the in- 
nominates is subluxated in its relation to the sacrum. There 
may also be a lymph blockage at the terminals. This must 
be determined, as in no case, unless there is terminal lym- 



156 Practical Visions 

phatic drainage, can we expect to have perfect drainage 
from the ankles, for the lymph, in part at least, must event- 
ually reach the thoracic duct and through that the left sub- 
clavian vein. 

We are of the opinion, however, as frequently expressed 
in the Journal of the International Society for Lymphatic 
Research, that a great deal of the lymph is taken up by the 
veins; otherwise, the mechanical arrangement for the hand- 
ling of the lymph is out of all proportion to what has been 
described in the various texts on physiology. 

We want the young practitioner to get the vision of 
making accurate diagnoses as early as possible. We want 
him to consider the entire body as one machine, that all of 
the component parts are interrelated, not only from a vas- 
cular standpoint, but from the standpoint of nerve con- 
nections as well. 

In order to give specific treatment, then, it will become 
necessary during the first two or three adjustments, for 
us to correct those specific centers which have control of 
the most strategic points. To give a general treatment 
and churn up the entire circulation of the body, as well as 
the various secretions, is contra-indicated. We must se- 
cure drainage at the most strategic points, and this can only 
be done by observing in particular the ebb and flow of the 
lymphatic circulation. By watching the edematous areas 
in various parts of the body, we may very readily be able 
to determine what part of the body is blocked, from a lym- 
phatic standpoint, and what areas are lacking in the lymph 
fluid. 

Our great fault has been in trying to give systemic 
treatment in every instance, when specific treatment, at 
specific nerve centers, is of far greater value. It is also a 
less tax on the patient, and a more speedy recovery follows, 
for we have not, in any instance, tired our patient. 



CHAPTER XVIII 



DIAGNOSIS 



CHAPTER XVIII. 

DIAGNOSIS 

The standard by which a physician is judged is usually 
one of diagnosis. When a physician has the reputation of 
being a diagnostician, he seems to stand well in the com- 
munity; that is, if he lives up to that reputation. 

Most physicians pride themselves on being good at 
diagnosing. As the human machine is constructed prac- 
tically the same in all instances, in that we have a certain 
number of bones, muscles, nerves, blood vessels, and so 
forth, the laity do not understand why it is such a difficult 
task for a physician to make an accurate diagnosis in any 
and all instances. It is only after a student has spent two 
or more years in a therapeutic college that the idea dawns 
upon him that, while there are a certain number of bones, 
muscles, and so forth, in the human anatomy, yet there is 
a possibility of disturbances and disorders attacking var- 
ious tissues in various places, including not only the frame- 
work, from an osseous standpoint, but pressure directly or 
indirectly through contracture produced by the various 
measures that are not only unnatural, but unexpected in 
many instances. 

When a physician realizes that his diagnosis depends 
upon a thousand and one conditions, so to speak, in that 
not only the chemistry of the human body must be de- 
termined, from a secretory and metabolic standpoint, but 
the relative position of the organs in their various regions; 
the varying quantity of the fluids in the body; the tone, 
or lack of tone, in the muscles; the degree of anemia that 
so often exists; the activity or inactivity of the ductless 
glands; the variation in the endocrines; and so on through 

—159— 



160 Practical Visions 

the entire list of organs and tissues that functionate in some 
manner or other continuously throughout the entire sys- 
tem; he feels his position keenly. 

It is unwise in any instance to give a systemic treatment 
of any nature until an absolute routine examination at least 
has been given. This does not account for special tests and 
examinations that may be indicated in each particular case. 

In the group clinics that are being conducted all over 
the country, following along the line of the original clinic 
in Rochester, physicians are becoming more accurate, sys- 
tematic, and complete, if we may speak in that manner, in 
the examination of their patients. 

The old school practitioner, especially in the rural dis- 
tricts, was supposedly an authority on every known ail- 
ment of the human body, even to the condition of the teeth — 
whether or not they should be extracted or treated in any 
manner whatsoever. He was not only considered to be a 
specialist in gynecology, but in everything from obstetrics 
to infectious diseases. We now refer to these instances 
almost with amusement, and we are pleased to know that 
the general practitioner, when confronted by a condition 
that does not manifest itself plainly to him, secures the ad- 
vice of some specialist in a group clinic, or in private prac- 
tice, who has devoted his entire time and attention along 
that particular line. 

Postmortem findings, in connection with some of our 
great hospitals, prove that diagnosis has been made incor- 
rectly in a great percentage of cases. Now, this being true, 
wherein does the fault lie? 

We understand that in order to be able to make a proper 
diagnosis a physician must not only be familiar with his 
anatomy, physiology, pathology, and so forth, but he must 
also be a master mechanic, in that the human body is a ma- 



Diagnosis 161 

chine. The study of applied anatomy is one of the most 
essential, not only surgically as we have a number of text 
books on surgical applied anatomy; but applied anatomy 
from a mechanical standpoint as well. This is not taught 
in the medical colleges. It is taught only in the osteopathic 
colleges. The application of each phase brought out, in 
that the relations of the various tissues are taught from an 
applied standpoint, can be figured out only as we consider 
that the body is a machine, and that structural changes 
take place, through accidents, stress, and outside forces 
that are not taught in the older schools. 

In order to be a good diagnostician, it is not enough, 
therefore, to have a complete knowledge of the human 
body, from a chemical standpoint, in relation to the various 
secretions, endocrines, and so forth. We must also be 
able to determine upon examination wherein structural 
changes have caused perversion, not only in the nerve tracts, 
but also in the blood vessels and various tissues and organs 
that make up the composite whole. 

It will all depend upon the viewpoint the practitioner 
has, as to his ability to diagnose a case after thorough ex- 
amination. If his viewpoint is distorted to the extent 
that he is not familiar with the physiological movements 
of the spine, he will not be able to make a complete diag- 
nosis in any instance. If, for any reason, he has not been 
trained as to the effect of disturbance on various nerve 
centers, in their relation to organs and tissues, he will not 
be able to diagnose accurately in any instance. 

Until Dr. A. T. Still discovered the principles and 
practice of osteopathy, there never had been a complete 
diagnosis made in any instance in the world's history. The 
ideas brought out by Dr. A. T. Still absolutely revolution- 
ized the therapeutic reckonings. The older method of 
(ID 



162 Practical Visions 

diagnosing from symptoms, subjective and objective, did 
not include the most important phase from a diagnostic 
standpoint. The osteopathic physician, who goes through 
the college and fails to grasp the idea relative to applied 
anatomy, will not be able to make the same diagnosis as 
the student who has a broader concept, and who realizes 
the significance of pathological findings in their relation to 
the tissues from an applied anatomy standpoint. All 
through the entire course, the applied anatomy viewpoint 
must be kept in mind. Even in the dissecting room, as 
well as in the technic department, the student must ever 
be on the alert to determine the applied viewpoint in every 
instance. It will be necessary to combine all of the various 
sources of information in relation to the human body when 
making the diagnosis of some bodily perversion. Every 
pathological phase must be deduced back to the point where 
the primary lesion existed. The reasonings made by an 
osteopath include the framework of the body and its struc- 
tural arrangement, from both a normal and an abnormal 
viewpoint. 

The reason some of our younger practitioners fail to 
get the proper viewpoint in making the diagnosis, is because 
they cannot collectively assimilate the various workings of 
the human anatomy in all of its various phases and realize 
that the disturbances manifested, when making an examina- 
tion, are due, in most cases, to a systemic disturbance that 
includes the entire central nervous system and its various 
connections. 

No organic disease can exist without proportionately 
affecting the entire body. No one nerve can be irritated 
or disturbed to any extent, without disturbing the harmony 
of the entire system. There is no such a thing as a local or- 
ganic disturbance. We have to consider, in each instance, 



Diagnosis 163 

the various reflex propositions. We have to remember the 
relation of the various nerve branches to the central nervous 
system. We must consider the various nerve tracts that 
carry different impulses; the different motor tracts that 
control and supply certain areas; and, at the same time, are 
under the great central nervous system. We must keep in 
mind the various areas of the body that are controlled by 
certain nerves through certain nerve centers; the distribu- 
tion of the vasomotors; the motor, and the sensory impulses; 
and, above all, the fact that all of the local centers are sec- 
ondary to the great controlling center located in the brain. 
We must keep in mind the various circulations; the arterial 
supply; the venous return circulation; and the lymphatic 
circulation that permeates almost all tissues. It is imposs- 
ible to be too careful about making a diagnosis. The more 
accurate the diagnosis, the more readily we will understand 
the case and secure results. 

It may take the young physician a little time to get 
his bearings and become familiar with certain phases, es- 
pecially where there is more or less metabolic disturbance, 
but in time the young practitioner will begin to realize that 
each case is individual in itself, in that a different diagnosis 
will have to be made than in a previous case of a similar 
nature. No two cases are alike. The symptoms in one 
case never tally with those in another, in every detail. The 
various combinations that go to make up a diagnosis are 
so numerous that it would be impossible to compile in any 
book all of the various manifestations that are shown in 
all diseased conditions. 

If the young graduate is well posted in all of the var- 
ious subjects, it will be no trouble, in a comparatively short 
time, to work out, from symptoms, a diagnosis that will 
be sufficiently accurate to enable him to apply proper tech- 



164 Practical Visions 

nic. It requires continuous study in order to keep in mind 
applied anatomy, and especially pathology, as based upon 
the reasonings from an osteopathic viewpoint. No book 
has yet been written, on certain subjects that are most im- 
portant to the osteopath. There is a vast field for those 
who are inclined towards research work, to give in detail 
the findings that are so much needed at the present time. 
We are, as yet, a new school. We have not, as yet, got all 
of our bearings; but, in time, we trust that we will be able 
to secure a text book that will give the students a better 
knowledge of how to make a diagnosis than is contained in 
the text books of the older schools. 

Students often realize, while going through college, the 
need of better text books, that is, from an osteopathic stand- 
point, and oftentimes they feel that some day they will be 
able to get out something along that line; but, when enter- 
ing upon practice in a new field, their minds seem to dwell 
more upon establishing a practice and they soon drift away 
from their original ideas and determinations, and we find 
very few who take sufficient interest in their work and 
studies to do sufficient research work that will be given to 
their fellow men. It does seem, with all of the findings that 
are recorded in the various books in the country, collected 
through all the ages past, especially during more recent years, 
that we should be given sufficient information to enable us 
to go ahead and work out in detail certain conditions upon 
which we could make a more accurate diagnosis. 

There are very few in any profession who are really 
studious, and who can do original work to the extent that 
they can give something new to their fellow-men. How- 
ever, there are a sufficient number of students who could 
do this if they would apply themselves, and we are hoping 
that in the next few years a number of our osteopaths will 



Diagnosis 165 

get together and get out textbooks along the line of path- 
ology, applied anatomy, neurology, and so forth. We have 
a field in osteopathy that is second to none. We have a 
greater opportunity to do research work than has the older 
school. We have a broader viewpoint; we have an applied 
anatomy vision that is not embodied in the course of any 
of the older schools. We have, as a rule, a more thorough 
knowledge of the human anatomy, in that we spend more 
hours and study more carefully the details found in the 
human body. Upon this working basis, it should be no 
great struggle for us to bring out new phases relative to 
diagnosis that will enable us to make a diagnosis that is 
most complete in every respect. 

While we are not able, at all times, to discern certain 
internal conditions, we should in time evolve principles that 
will enable us to make more accurate diagnoses in every 
instance. 

The principles of osteopathy are true to nature; true 
to the bodily mechanism; and the findings that are worked 
out from an applied anatomy standpoint, as well as from 
a pathological viewpoint, backed up by structural defects 
and tissue disturbances, enable us to visualize conditions 
that cannot be worked out from any other viewpoint. 

Every year that you practice, if you are conscientious 
and studious, you will be able to make a better diagnosis 
than you did the year previous in similar cases; and after 
ten years' practice, you will have a viewpoint that will 
be so far ahead of the one you had a decade previous, that 
you will wonder why you did not understand certain condi- 
tions at that time. 

We learn by experience. We also can learn by study 
and research. No man makes a success in any particular 
line of work unless he gives it thought and attention. Pride 



166 Practical Visions 

yourself on making clear diagnoses, and never feel that you 
have mastered the subject entirely. It is a life's work, and 
a pleasant one, if you have put your whole soul into your 
work. It takes daily enthusiasm in order to accomplish 
anything. 

After a person loses his enthusiasm, his work is never up 
to par. Enthusiasm carries us along from day to day, and 
makes work a pleasure, where otherwise it would be drudgery. 



CHAPTER XIX 



BE SPECIFIC 



CHAPTER XIX. 

BE SPECIFIC 

Peanut vendors, I dare say, are as sincere and do as 
much thinking, according to their limited cerebral capacity, 
and lie awake as many hours at night, as some of the great- 
est statesmen and business men who rule the affairs of the 
world. 

It is always amusing to me to have some unsuccessful 
or limited person in any walk of life step up to some success- 
ful business magnate and try to tell him how to do things. 
It is like fellows on the program of the American Osteopathic 
Association telling about the wonderful things, from a theo- 
retical standpoint, which can be accomplished, and how to 
do this and how to do that, and all the rest of the year in 
their home practice and by the bedside you hear nothing in 
particular of their work. 

We have not lived up to our promise, as practitioners 
of osteopathy. We have not kept the practical vision that 
Dr. A. T. Still gave us. We have not followed his motto 
or the example that he set. We have given patients the 
impression all over the country that we make appointments 
one-half hour or possibly one-quarter hour apart, and that 
they must come at a certain time in order to receive full 
time treatment This is where we have fallen down, and 
we have no occasion to blame any other school if we are the 
losers. 

Would a Barker, of London, England, give his patients 
the impression that he had to manipulate or adjust an ankle 
or knee, or some part of the spinal column, and take a cer- 
tain length of time for it? 

Would Reese, of Youngstown, put in a certain length 

—169— 



170 Practical Visions 

of time in order that the patient would feel that he had re- 
ceived his money's worth. I want to say here that the 
appointment sheet idea is all wrong, and that when we 
make appointments ahead so that patients may come at a 
certain time, we are giving them the impression that they 
are to be given a certain length of treatment, and they will 
naturally expect it. In other words, the lady patients, for 
instance, arrange ahead of time, so that they can practically 
take a half day off in order to have their treatment and get 
back home. The proper way to go about this is from a psy- 
chological standpoint. We all know that in business houses, 
department stores, and even in our practice, there are cer- 
tain times and days when people come in droves, and that 
we must not have such registered routine that we cannot 
adjust ourselves to the condition. I know of osteopaths 
who, when called over the phone to make certain appoint- 
ments, say, "No, I am booked up for the day. You will 
have to come tomorrow." Now, let me tell you right here, 
and I am a frank speaker and speak according to what I 
put into practise, that when a patient calls up and is in a 
hurry for treatment I give him the time that suits him. 
Suppose you have twelve or fourteen in your office at one 
time; they can easily be cleared out in one hour, and by 
using a little tact, you can get certain patients to wait for 
a few minutes by telling them that some one is going to 
catch a train, or is in a great hurry to fill some appointment, 
and you will have no difficulty at certain times in handling 
the overflow which is liable to happen one or more times 
every week. 

You have followed more along the line of the dentist, 
who makes appointments for a definite length of time, at a 
definile period in the day. This is absolutely unnecessary 
and all wrong. 



Be Specific 171 

Throw your appointment sheet to the wind, and have 
an office girl who knows your work so well, and who is so 
well posted on just what you can do and what you cannot 
do, that she will make the appointments without any sheet 
at all and will never get you overloaded at any one time. 

Now, I am speaking from experience. We started out 
with the ordinary sheets, which we put up ourselves. They 
held names of about twenty-five patients a day. We en- 
larged this until we had a sheet that would hold sixty a day. 
We finally threw the sheets away, and although all of the 
hours and divisions of hours were on these sheets, we do 
not use them at the present time; only one large sheet for 
putting down the names of the patients as they come in, 
also recording their credit. 

When a patient phones, instead of saying "Well, let 
me look at my sheet and see if we have any time, " the nurse 
says, "What time do you want to come? Could you come 
at a certain hour?" If he says, "No, I would rather come 
so and so/' she says, "All right, come ahead. The Doctor 
will take you as an emergency case. " 

Now, boys, I am, as I said before, talking from exper- 
ience. With five treatment rooms, we find that we are short 
at times for space, but by a little strategy, that is, treating 
those who will get out in quick time, or some child, or busi- 
ness man who is in a hurry, we seldom have any difficulty 
in keeping our office clear. We have no large waiting room, 
and were I to arrange an office again, I would have no wait- 
ing room, any more than along the hallway. We do not 
want patients sitting around. We want to put them in a 
room, treat them, and get them out; we do not want pa- 
tients lying around after treatment; we send them home, 
that is, the ladies, to lie down and rest for one hour. We 
never allow them to go shopping after a treatment. They 



172 Practical Visions 

must go straight home. The men can do as they please, 
as our treatments are exhilarating in nature and they can 
work all the harder for having had a treatment. You see 
the advantage in giving short, specific treatment is that 
we do not tire our patients. They do not feel as if they 
would like to lie down and rest, and we do not have any 
trouble from having the ladies block the rooms, as they 
are told as soon as they have their treatment, that they 
must dress and go home 

Regarding examination, we seldom treat a patient, when 
we examine him, unless he is suffering in someway; but the 
examination, a thorough one, must come first. We go 
over the lymphatics. You will have read ere this, the article 
in the A. O A. Journal on "How to Make a Lymphatic 
Examination," so we do not care to go into this again. It 
is also published in detail in Applied Anatomy of the Lym- 
phatics, which is being read by a great number of the pro- 
fession. After making the lymphatic examination, we 
always take the blood pressure, even if the patient has had 
treatment from some other osteopath, that is, a traveling 
man or an unsatisfied patient, which by the way, we all 
have, and listen well to the heart action and the lungs, and 
if necessary make blood tests, if there is any tendency towards 
anemia or any pus present in any part of the body, indicated 
by enlarged lymph nodes. We have the best Leitz micro- 
scope that is made; also blood testing apparatus, as well as 
a chemical laboratory, and in no way neglect the patient's 
condition, and yet do not take all day to make an examina- 
tion. Be so alert and keen in your work that you will sum 
up the patient's condition as nearly as possible in the short- 
est length of time. Cut out the talk, and work. Get down 
to business, and don't let your patient talk either, other 
than to give you a few subjective symptoms that you may 



Be Specific 173 

call for. State definitely that you find so and so recorded 
on the spine; that a certain injury happened a certain num- 
ber of years ago, which you will be able to determine after 
you practice a few years, almost specifically. Tell him how 
he fell, and about how long he was laid up, and the symp- 
toms that followed the fall, and so forth. This can all be 
done after a few years of practice, so that the patient will 
know what you are talking about. 

After the examination, hand a specimen of urine and 
the brief slip, upon which you have written the essential 
points, to the nurse, and she will give the patient a time 
for report, diagnosis and prognosis, on the next day, and go 
to your next patient. All this need not take more than a 
few minutes' time. 

Get away from that old idea of having to ask a patient 
a thousand questions. Be able to read the patient your- 
self, and not depend on what the patient says, as he may 
not have the right idea of his case at all. He may be going 
by what some doctor told him at some previous date. Al- 
ways ask the patient three questions — "Have you ever had 
an operation?" "Are you constipated?" "Do you have 
headaches?" These three will give you a better line on the 
case than anything else you may ask, as far as we know. 

When the patient comes in for treatment and you go 
into the room, do not sit down or let him sit down and start 
saying, "Well, how do you feel today?" Simply have him 
jump on to the table, and if he will not lie down, and wants 
to talk, tell him in a very nice way to do so, that you will 
listen while he is talking and at the same time start in giving 
such a good specific treatment that he will be glad to hush 
up. We have found that these short specific treatments 
are absolutely best for patients and that they like them. 
They like for you to get down to business and work. 



174 Practical Visions 

If they start talking politics, religion, or anything else, 
or ask you about osteopathy, tell them that you will explain 
when you get through, and when you get through they will 
have forgotten it. Do not forget, though, to have the pa- 
tient get a booklet on osteopathy, which will be in the room, 
or handed to him by the nurse as he goes out. They can do 
their own reading; this will save time, and the literature 
which is published at the present day is much better worded 
than anything we can say. 

Save your breath. It means energy; keep your mouth 
open only to inhale more air. If you want to be strong and 
healthy in your practice, treat with your mouth open — not 
wide open, but sufficiently to inhale plenty of air. I have 
noticed a lot of osteopaths who hold their mouths so tight 
when they are not talking that they have insufficient air. 
It does not hurt to breathe through your mouth in a warm 
room This is one way I have kept well all of these years. 
There is another way which I will tell you about some time. 
I have told a great number of osteopaths and it positively 
keeps you from having a sore and sensitive abdomen, and 
the typhoid fever that so many of our boys get; as well as 
enteroptosis through their backs aching, their nerve centers 
being undertoned, and venous stasis in certain cases. 

Regarding attire in the treatment room I wear a shirt- 
waist effect the year round, with four point suspenders, 
and simply work in my shirt and trousers. As soon as I go 
into a room I pull off my coat. They like the idea — getting 
down to business. They want you to concentrate your 
entire time and energy on their cases; they want you to 
remember what you found out and told them the first time 
you examined them. Don't forget this. Take a little 
private special memory course of your own, and be sure you 
remember what a patient has said and what you have told 



Be Specific 175 

him. This is of vital importance. Start your treatment 
in such a way that he will know that you are all eyes and 
ears and interest in his case. 

While we are doing this work, let us devote our entire 
time and energy to it. When we get older we can retire 
from practice and think of something else. If a patient 
persists in talking, say, "Excuse me, but the lesion that I 
corrected the other day seems to be a little better. I thought 
you would like to know," and if he starts talking a little 
later on, ask him how that symptom he referred to the other 
day has been, and keep his mind off of the talking point, as 
much as you possibly can. 

Always leave your patient feeling good. As soon as you 
notice that he is tired or droopy in any instance, quit right 
then — absolutely quit, and do as little treating as possible 
when the patient is sitting up on the stool. There is where 
you tire your patient out — fiddling on the cervical vertebrae 
with the patient sitting up. It is liable to over-stimulate 
the nerves and cause either nausea or fainting. Get away 
from that. Do your treating while the patient is lying 
down, except a very small amount of specific treatment in 
the upper dorsal, with patient sitting up. 



CHAPTER XX 



"FORGET IT" 



(12) 



CHAPTER XX. 

"FORGET IT" 

When a boy, I had the greatest admiration for physi- 
cians. My father's home seemed to be a hanging-out place 
for doctors. My father should have been a surgeon. Many 
a time he has assisted in emergency cases. He has nerves 
of "steel." Strange, how we miss our callings sometimes 
and drift away, through environment, into unexpected 
fields, and thereby fail to give to the world what was nat- 
urally expected of us. 

In later years, I found out that physicians have their 
weaknesses also, and that while they may know the human 
body to a greater extent than any living professional man 
outside of the therapeutic band, yet there seems to be an 
inherent weakness, or lack of the training that should exist 
in order that the physician may be capable of rounding him- 
self out sufficiently on all sides. 

People naturally expect a physician to be an encyclo- 
pedia on any therapeutical subject, and, undoubtedly, they 
are better posted on one theme than any other class of peo- 
ple, as they make that their business; but we find that doc- 
tors have their own troubles, and that, in many instances, 
they are incapable of self-control sufficiently to throw off 
matters that worry them. Consequently, the average 
length of life of a physician is slightly less than that of a 
business man. It is not because they lack knowledge of the 
physiological activities of the human organism, or that they 
do not know how to combat various diseases and patho- 
logical conditions in the majority of cases, but it is that 
element of "human nature" that, by the way, makes the 

—179— 



180 Practical Visions 

world akin, that seems to "get" a physician the same as 
any other person. 

A young doctor starting out in his practice will often 
lie awake nights worrying over his cases. Instead of giv- 
ing the patient the very best that he has in him at the time, 
and dismissing the case from his mind, other than to post 
up on the disease if he is not entirely familiar with the sub- 
ject, he will wonder and worry to the extent that his nerves 
will almost become shattered in the first few months of his 
practice. Few physicians entirely escape this, and while 
it may be true that the more sensitive a physician is, the 
greater interest he will show in his patients, and the more 
good he will accomplish, yet a physician must school himself 
and so train his mind that he will not be drawn into this 
nervous whirlpool by over-worry and anxiety. 

The old expression "Lest We Forget," should be 
changed to the newer expression "Forget It." This may 
appear like slang, but we have found that this little motto 
has been of great value to us in a great many instances; in 
fact, from a psychological standpoint, almost all of the 
trouble existing in this world is from the point of remem- 
brance. 

We are urged in school to study history — the rise and 
downfall of nations, especially the downfall and cause of 
downfall. We, as a people, are more or less fond of an- 
tiques. We love to recall those good old days when certain 
things existed. We are constantly saying, "Bring back 
those good times that we had years ago, and we will be 
happy." 

A time is coming when we will live in the future. We 
will so dwell on the future that, as Ralph Waldo Trine says, 
"Each day will be a new beginning." We will simply 
use the accumulated knowledge that has been registered on 



"Forget It" 181 

the cerebral cortex to aid us in building new structures 
and accomplishing greater things. 

There is no reason why a young physician should not 
have a viewpoint as well as any one else. The mere fact 
that a physician is supposedly posted in anatomy and physi- 
ology, is no reason why we should suggest that he has not 
a heart in him, a sensitive nature sometimes, and a longing 
for the betterment of humanity. If the college student 
will so post himself while going through school that he will 
feel that he is master of each subject, it will be an easy mat- 
ter for him to apply this knowledge when starting in prac- 
tice, and by the use of reference books and the latest jour- 
nals, be able to keep abreast of the times. After all, no 
physician, with very few exceptions, has been known to 
make a tremendous success unless he has been sufficiently 
interested to keep up to the minute in everything that is 
going on in the therapeutic world. 

All feudal wars, community disturbances, duels, trage- 
dies of every kind, invariably refer back to some time when 
some incident has happened that has made mental im- 
pressions which, through recollection, have exaggerated 
themselves sufficiently to deepen the nerve tract impression 
and reflexly disturb the thermogenic and vasomotor centers 
sufficiently to arouse agitation in the cerebrospinal mecha- 
nism. 

Physicians are looked up to in each community from a 
respectful standpoint, providing they are worthy physi- 
cians, and no man should stand higher in his community 
than a physician. His ranking is near to that of a minister 
at least. Therefore, we should be proud to be physicians, 
and we should hold ourselves in such an attitude that we 
can constantly give to the people advice, from a physical 
and hygienic standpoint, at least. The time is coming 



182 Practical Visions 

when a physician will be looked to for psychological and even 
psychic advice. A part of the ground may be covered by 
the minister, as well as the physician. The therapeutical 
phase should be dealt with entirely by the physician, al- 
though we have known some ministers who were very well- 
posted along psychological lines. 

Start out in your work as a practitioner feeling that 
you should be symbolic not only of optimism but also of 
physical activity, endurance, broad mindedness in your line 
of thinking, and freedom from certain lines of mental reason- 
ing that are so common among those who do not know the 
activities of the nerve tracts. The physician's viewpoint 
should be so much broader than that of the layman that he 
should be able almost to read and understand human na- 
ture, not only from a physiological and a pathological stand- 
point, but also from a mental, and feel master of the situa- 
tion. His mental reasonings should correspond with a 
line of thought that is much better connected, through his 
superior knowledge of the nervous mechanism. 

Let us get away from the old idea of recalling things. 
Let us make each day a wonderful day, in that we have the 
possibilities in us of creating new nerve tract impressions, 
and reaching brain cells from a different viewpoint, and 
impressing them like a stamp that is applied to a new piece 
of wax. 

There is no limitation to the human brain, to its con- 
ceptions, its revelations, and its capacity for rearranging 
ideas in order to make impressions that will give us a new- 
viewpoint. A physician should so delight in developing 
these centers and nerve tracts, through better cerebral co- 
ordination, that he will in time develop his brain from a 
many-sided standpoint until his views will be of an entirely 
different nature than those of people not posted on human 
anatomical and physiological workings. 



" Forget It" 183 

There is no greater field in the world to work in than 
the therapeutic, and if the young physician gets the proper 
viewpoint early in life, and realizes the great possibilities 
along the various lines, he will simply be carried along by 
the visions that he will create from day to day, through 
having a practical vision to start with. 

The last word has not been said regarding diagnosing, 
and possibly will not be for decades to come. There is a 
greater chance at the present time for a young physician to 
make himself world famous and make startling discoveries, 
than ever before in the history of medicine, in the broader 
sense. The powerful microscopes accessible today; the var- 
ious paraphernalia used in making diagnosis, in the way of 
heart tracings especially; the peculiar development of sensi- 
tive touch in the well-trained osteopath, which was unknown 
to the physician of a few years ago; places the young phy- 
sician at the present time on a plane much superior to any 
that has ever existed, and if he will but get an optimistic, 
practical viewpoint, he will not look back and wish for days 
gone by, but will plunge into the future in his mental reason- 
ings and benefit humanity more than he ever dreamed of. 



CHAPTER XXI 



CLINICS 



CHAPTER XXI. 

CLINICS 

For years we have felt that the wisest thing a young 
physician can possibly do is to establish a clinic in connec- 
tion with his work. 

Were I to go to a new field to practice, either in a small 
town of two thousand or over, or in a large city, the first 
thing I would do would be to establish a free clinic, or assist 
in one already established. 

Let us discuss the psychological side of it, as well as the 
relief side, and see if we cannot prove that work in a 
clinic is of more value to you than you would ever dream of, 
unless you had undertaken the task before. We would not 
call it a task. It is not only a pleasure, but most refresh- 
ing, and we have learned more about infantile paralysis, 
scoliotic conditions, and various forms of nervous disorders, 
from St. Vitus dance to convulsions, than we have in any 
other way; in fact, I never did really understand the possi- 
bilities in treating infantile paralysis until we established 
a free clinic where we had from eight to ten infantile paralysis 
cases at a time, along with a much greater number of sco- 
liotic cases. 

Personally, I find it a tremendous tonic to conduct a 
clinic. For years we held it three times a week. We now 
hold it twice a week, Tuesday and Saturday mornings. We 
commence at eight o'clock. While it is necessary to rise 
an hour earlier, in order to be at the office a little before 
eight o'clock and welcome the children as they come, yet 
think of the mothers who have to rise, dress, wash, feed, 
and bring their children to the clinic, and likewise be here at 
eight o'clock. 

—187— 



188 Practical Visions 

We have possibly as large a clinic during the length of 
time, as you will find anywhere. Forty-eight in one hour 
and fifteen minutes is not uncommon, and unless we have 
forty or more, we are not satisfied at all. Imagine the tonic 
effect on a doctor when the mothers bring their children to 
have them treated, because they have seen other children 
cured of a similar trouble. Imagine the thrill that goes 
through a doctor when he realizes that he is taking off braces, 
crutches and casts, from those who have been shackled some- 
times for life at the suggestion and hands of the orthopedic 
surgeon. 

To me, there is no greater pleasure in life than conducting 
a free clinic, and I am frank to say that had I sufficient 
money, or if some one would endow me sufficiently to pay my 
expenses the rest of my days, I would treat one hundred 
children free, twice a week, as long as I was physically able 
to do it. This would take about two hours and a half each 
day, and thanks to specific osteopathy, the results would 
compare with those of any orthopedic institution in the 
land, and without a single instrument or cutting in any 
manner, restoration would be made, through the nerve 
centers that control the circulation that supplies the cord 
sections, as well as giving stimulus to the motor impulses 
as they leave the spinal cord. 

There is no comparison between what an orthopedic 
surgeon can do and what osteopathy can do. True it is that 
an orthopedic surgeon has work to do that manipulation 
alone cannot do; that is, there are a certain number of cases, 
such as talipes in its various forms; but when it comes to 
muscle transplanting, or tendon shifting, in order to bring 
about strength and motion in the withered limb, I am 
sure that any good osteopath will take case for case with 
any orthopedic surgeon and without cutting in the least, 



Clinics 189 

make resotration in a greater number of cases than the 
orthopedic surgeon will do by his transplanting method. 

Then again, we have cases of scoliosis in every form con- 
ceivable, even to kyphosis and Pott's disease, which we 
hesitate to take, and refer them to the orthopedic surgeon, 
and we are not so sure that the orthopedic man will do 
much better than nature herself has done. 

In the earlier stages, the orthopedic man will accom- 
plish much, but there comes a time, even in a child's life, 
when it may be wise not to interfere unduly with certain 
conditions. However, I would trust a case absolutely in 
the hands of any of our good osteopathic orthopedic sur- 
geons, and in the above references, for comparison's sake, 
we have invariably referred to orthopedic surgeons of the 
older school, who are not trained along osteopathic lines, 
who have never had the osteopathic vision, and who know 
little or nothing about even a sacro-iliac lesion. We are 
proud of our osteopathic orthopedic surgeons. They are 
trained to know the osseous framework from a different 
standpoint than that of the older school. They are quite 
familiar with the fact that adjustment will correct lesions, 
and that osseous lesions cause a great deal of the trouble in 
the human framework in most of the various diseases. 

So, it is always a pleasure to send cases to an osteo" 
pathic orthopedic surgeon, after having tried osteopathy 
first; that is, the manipulative part, or adjustive work, such 
as Dr. Still longed to talk about and loved to demonstrate. 

I love to think back on pleasant things; I love to for- 
get unpleasant things. There are a few things that we can 
recall that stimulate us, and one of these precious things is 
the memory of the Old Doctor; the time when he dwelt 
among us physically, and when people flocked from all over 
the country to be restored to health. 



190 Practical Visions 

Never will I forget that memorable day when the Old 
Doctor, sitting in the back yard, was approached by a mother 
from Colorado with her little child in her arms, beseeching 
the Old Doctor to make physical restoration. Without 
getting out of his chair, the Old Doctor took the child on 
his lap, and in less than a minute's time stood the child on 
the ground, and the child walked. 

Who else in the world at that time could correct a femoral 
lesion, or luxation, complete, in that the head of the femur 
was entirely out of the acetabulum; and who but a Still, at 
that time, could so thoroughly understand the mechanism 
of the hip joint that, by a single twist, without any assistance, 
he could replace the head of the femur in the socket and there- 
by make the child normal again from a mechanical stand- 
point. 

The Old Doctor did not always use a treatment table. 
He was known to back a patient up against a fence; put him 
on the sidewalk, or the station platform and correct his 
lesions, and in some instance, take away the crutches. 

Some will remember that famous case where the Iowa 
man was returning home, not being satisfied with manipu- 
lation by some of the students. The Old Doctor, hearing that 
the man was headed for home, hurried to the station, and 
grabbing the man before he boarded the train, asked him 
why he was going home. He commanded the man to lie 
on the platform, set his hip, took his crutches, and re- 
quested him to stay two or three days, and never were the 
crutches used again. 

Who at the present time practicing osteopathy could 
perform a similar feat to the one above recorded? Are we 
so well posted in human anatomy and bodily mechanism 
that we would attempt to make corrections in an instant, 
without proper arrangement or accommodations, and ex- 



Clinics 191 

pect complete restoration? It is almost inconceivable that 
any one practicing at the present time would attempt any 
such procedure, or even have sufficient confidence in his 
anatomical knowledge and mechanical skill to perform the 
feats that the Old Doctor did. 

After the clinics each morning, you feel as if you are 
limbered up and ready for a day's work. Forty-five patients 
will take no particular strength out of you, if you are thor- 
oughly imbued with the osteopathic spirit. If you are ab- 
solutely anxious for children to be restored, for a better 
generation from a physical standpoint, you will take hold of 
these children with a zeal that will equal that of panning 
gold or washing diggings in a placer mine. 

My understanding of a true osteopathic physician is 
one who is so imbued with the spirit of osteopathy that he 
will live it, talk it, dream it, and when he sees a case where 
there is mechanical malalignment, will not be able to 
hold himself until he can get hold of that case and make 
physical restoration. 

If you are not connected with a clinic, start one imme- 
diately! 



CHAPTER XXII 



FEES 



(13) 



CHAPTER XXII. 

FEES 

There is one thing about practicing straight osteopathy, 
as they call it — unless you are a clever diagnostician and a 
still more clever adjuster, or manipulator, you will never 
make any great fortune in conducting a practice wherein 
straight manipulation is done. However, we have some 
of the old timers who can give evidence that there is suffi- 
cient remuneration in plain adjusting to warrant the contin- 
uation of their practice and satisfy all of the necessary wants 
of life. 

I have often wondered why there are not more os- 
teopaths who have become so efficient and so enamored with 
the science of osteopathy that they would be thoroughly 
satisfied with their practice, without spending time and 
money to venture into some new line of work, which, al- 
though possibly osteopathic, yet is sufficiently different to 
throw one out of the genuine field of osteopathy. Person- 
ally, I am most decided and most determined, regarding 
manipulative treatment; also, I am thoroughly convinced 
that I can make as great a headway practicing straight os- 
teopathy as any ordinary specialist or osteopath who dab- 
bles in adjuncts. Were I not satisfied with osteopathy and 
the methods employed, as demonstrated by Dr. A. T. Still, 
I feel that I would give up the title and branch off into other 
fields, and not refer to myself as an osteopath in particular. 
I have always contended that the people should be trained 
to, and in time would, realize that specific adjustment is the 
greatest single therapeutic factor in the world. 

Had we the opportunity to make comparative tests 
regarding the treatment of typhoid fever, or malaria, for 

—195— 



196 Practical Visions 

instance, in some hospital where fifty per cent of the cases 
would be handled from a medical standpoint, and fifty per 
cent from an osteopathic, there is no doubt in the world 
but that a true osteopath would be the winner in every in- 
stance. 

The same would apply to pneumonia, or even diph- 
theria, and osteopathy received its great impellent in the 
first place at Red Wing, Minnesota, when Dr. Still's son 
demonstrated what could be done in a diphtheria epidem- 
ic from a purely osteopathic standpoint. Just the 
other day, Dr. Hildreth and I were talking at Minneapolis, 
regarding that particular incident, and he was most familiar 
with that demonstration given in the early days of oste- 
opathy. 

We have referred in another chapter to the fact that 
when a physician is thrown upon his own resources and re- 
sponsibilities, he develops confidence and will invent 
methods and means of bodily restoration that otherwise he 
would not have, if he had the opportunity of covering up 
symptoms as the older schools do, or have done, with a little 
morphia, or some coal tar product. 

Any young man who will start out and go through an 
osteopathic college with the determination to be a proud 
follower of Dr. A. T. Still, and execute the principles of os- 
teopathy after graduation, conscientiously sticking to the 
practice end of osteopathy, will undoubtedly be a winner, 
and will command respect in any community. After all, 
it is a matter of confidence, backed up by good judgment 
and a thorough knowledge of the human body, that makes a 
physician capable where, in other instances the half-hearted 
man will never succeed to any great extent. 

It does seem as if we m 3 ght make ourselves proficient 
in one line of work in this world. There are men known to 



Fees 197 

be directors of five and six organizations, while other men 
are contented and feel overworked running a little corner 
grocery store. It is a matter of vision, practical vision, and 
development of the mind. The human brain, if at all nor- 
mal, is capable in any instance of development to the high- 
est degree. As we have stated before, it is impossible for 
any human brain to be developed, in any lifetime, more than 
a fractional part of its functional capacity. 

The reason why some osteopaths fail is simply this: 
They do not put their whole hearts and souls into their work. 
They are not sufficiently enthused to take that particular 
interest which is necessary in order to make a physician 
successful. There are too many " lukewarm" physicians. 
They prefer almost anything to sitting down and reading a 
book od physiology, anatomy, or psycho-analysis. The 
truth of the matter is this, if a physician really wants to be 
successful, he has to enthuse over his work so that it is a 
constant pleasure to do his work from day to day, and so 
that he will go to bed each night feeling that the next morn- 
ing will be a still greater day, in that he will have met new 
cases, or solved new problems which will come up from time 
to time regarding various diseases and symptoms. 

Even though a doctor practices for forty years, he will 
still have something to learn. No two cases of fever run 
the same chart, any more than two thumb prints will regis- 
ter the same markings or lineations. 

Some physicians are charged with taking extortionate 
fees. This may be true in some instances, but the best of all 
tests is a simple one — Are the patients satisfied? If a doc- 
tor holds his practice year in and year out and his practice 
enlarges each year, likewise his fees, where can the objec- 
tion come in? And should a physician be sufficiently generous 
hearted to conduct a free clinic besides his general practice, 
he should be given still more credit. 



198 Practical Visions 

There was a time in early osteopathy (and thank good- 
ness it does not exist to any great extent at the present 
time) when so many treatments were given in a certain 
period of time, and a certain number of treatments for a 
certain price. The better physicians at the present time 
charge either by the case, or by the treatment. Personally, 
we have found the most satisfactory method is keeping no 
books, and here arises a point that is possibly greatest of all, 
in that a physician treating a case time by time, and the pa- 
tient paying in the same way, he is at liberty to leave at 
any time, and it is the best test of the confidence a doctor 
has in his patient, and vice versa, that we know of. 

If an osteopath is sufficiently successful that he can 
hold a practice by stating to his patient, after examination 
and diagnosis have been made, that he reasonably expects 
a restoration after a certain period of time, and if the patient 
feels that the doctor is sincere and trustworthy, there will 
be no hesitation upon the part of the patient in taking that 
certain number of treatments. 

To my mind, osteopathic adjustment is the highest 
skilled work, from a manipulative standpoint, in the world, 
and possibly no surgeon or general practitioner of the 
older school could accomplish, in any instance, the same 
kind of work, were he paid any sum of money. The skill 
and dexterity of the osteopath's fingers is the highest manip- 
ulative accomplishment that the hands of man have ever 
known. The development of that peculiar sense of touch 
can only be brought about by continuous palpation, follow- 
ing, of course, a thorough understanding of the human body. 

After a few years of practice, it is quite possible for an 
osteopath almost to read the past history of a patient by the 
registrations that are found in the spine, dating back to a 
time when certain accidents have happened. Well do I 



Fees 199 

remember, in my student days, when one of the older teach- 
ers was demonstrating on a clinic case before a big student 
body, certain findings that were registered in the spinal 
column. While it seemed almost miraculous to me at the 
time, and while I thought that I should never be able to 
accomplish a similar diagnostic feat, yet I can perfectly well 
at the present time. It is like the beginner , who is most 
desirous of becoming an artist. He mixes his paints most 
crudely. He has in his mind the combination of colors to 
produce certain effects, but only the master artist can mix 
the colors with his brains, and put on those delicate touches 
that are impossible for the amateur to accomplish. 

The human framework, to an osteopath, is one field of 
pulsating tissue. He must keep in his mind all of the var- 
ious organs, as well as the structures. He must keep in 
mind the physiological effects that are produced by stimu- 
lation, or inhibition, as referred to by some authors. He 
must also keep in mind the fact that there is such a thing 
as an idiosyncrasy, even in the application of manipulative 
treatment, as well as in the field of medicine. 

We would advise the young practitioner to charge ac- 
cording to the field he is in, and have in mind constantly the 
raising of fees commensurate with his skill. After practicing 
for some time, and having the confidence that you can ac- 
complish more in five minutes than you could in three times 
five minutes when you first started practice, you are per- 
fectly justified in charging twice or three times as much. 

The question of fees need not enter into the proposition 
of general practice to any extent. It will regulate itself. 
As you get results, and patients become satisfied to the ex- 
tent that they send you their friends and relatives, you will 
change your fees according to the results you are getting. 

There may be those who charge too much, but there 



200 Practical Visions 

are many osteopaths who are not doing themselves justice, 
giving long treatments and charging little more than a 
general masseur or a chiropractor. 

There should be one great aim in a physician's mind, 
and that is to serve humanity and make each and every 
case a star case. If he keeps that well in mind, his prac- 
tice is assured, and he will never suffer for lack of funds. 

No student should ever go into osteopathy for the 
money that he may possibly make. If he does, he is liable 
to make a failure, but the student who takes a course in os- 
teopathy with the one thought in mind, of relieving suffer- 
ing humanity and pursuing a course of study that will give 
him the greatest possible knowledge along that line, will 
be the student who will make a success when he has grad- 
uated and gone out into the field. 

If you have nice offices in a down-town district, you 
must charge accordingly or you will find yourself running 
behind your expenses. If you have a small office in a small 
town, you must not expect to get the fees that the city man 
does. If you are a small town man, why try to measure 
up with the man who is used to a large city and capable of 
handling three or four times the number of patients that 
you can? 

All of these things must be figured out. The other 
day I heard a statement made by a man, regarding a class- 
mate of his, who has a much larger practice than he has. 
"Why that fellow was a classmate of mine, tarred with the 
same stick, and pursued the same course, and yet he thinks 
that he knows more than I do." Now, this is the wrong 
attitude. In any business or profession, one man will out- 
strip another from the very fact that he knows better how to 
apply himself to conditions and people, and is possibly a 
greater student. And, as we have explained in a previous 



Fees 201 

chapter, the physician who succeeds best after graduation 
is the one whose heart is deepest in his work, and who fol- 
lows up his studies by the latest ideas and methods of oth- 
ers, as well as the personal research that he does in his own 
office and laboratory. 

Go out into the field determined to make each succeed- 
ing year better than the previous year, and you will have 
no difficulty, if you put your whole heart and soul into your 
work, in making as great a success as you dreamed of when 
you first entered college. 



CHAPTER XXIII 



LETTER WRITING 



CHAPTER XXIII. 

LETTER WRITING 

This may seem an unusual subject in such a book as 
this, but after a little consideration of the subject, I believe 
you will agree with me that it is not such a trifling matter 
after all to consider letter-writing a significant point in a 
physician's practice. 

Those who have had the official reins in their hands, so 
to speak, know something about the receiving of letters 
written in longhand that are almost beyond deciphering. 
Just the other day I saw a seven page letter written by one 
of the oldest practitioners in the osteopathic profession. 
He sent the original to the person for whom it was intended 
and a carbon copy to the President of the American Osteo- 
pathic Association. It was a pleasure to have the oppor- 
tunity of seeing this letter, as it contained some very good 
ideas, but there were parts of the letter almost beyond the 
patience of a human being to decipher. It seemed almost 
pitiful to think that a man who had been connected so 
highly, in an official capacity, for so many years, should so 
impose upon his fellow officials as to expect them to decipher 
a seven page letter, closely written in longhand, with many 
of the words abbreviated 

There is no excuse for any one at the present day, in an 
official capacity, or even a physician in his own office, not 
to have at least one typewriter. The only alternative would 
be to have some one come in and take dictation and write 
the letters, especially when they are intended for those 
who are busy in the world's work. 

Many and many a letter we have had to have decipher- 
ed by some one else before reading it, in order to save time. 

—205— 



206 Practical Visions 

It is no trouble to pick up a typewritten letter and get the 
gist of it within a few moment's time, after which you can 
read it more carefully; but when we receive a letter of from 
two to seven pages, as we often do, even nine pages, written 
in longhand, we are of the opinion that there is lack of train- 
ing or lack of appreciation of the time of those who are so 
busy. 

A physician can have no better training than that 
resulting from the practice of dictating letters and articles 
day by day. The importance of well-typed letters, on good 
stationery, is, from a psychological standpoint, almost be- 
yond conception. About one typewritten letter in ten is 
anywhere near perfection from a typist's standpoint. One 
can almost judge the kind of practice a physician has by the 
letters he sends out. If you have never thought of this, 
try it out. Write a dozen letters, call for answers, note the 
kind of replies you receive, including stationery used, and 
see if you do not agree with me that the stationery and 
writing of the letters, whether longhand or typewritten, will 
indicate to a great extent the kind of practice that a phy- 
sician has. 

True it is that some of our best practitioners often 
scratch off a few lines to their friends, who are fellow prac- 
titioners; but those who have had experience in receiving 
and sending hundreds of letters a year, almost invariably 
use the typewriter to convey their messages. 

Elbert Hubbard set a wonderful example, in that he 
considered it good training, and a part of one's education, 
to have the best of stationery and the best possible type- 
written expression in every letter. He was one of the origi- 
nal watermark people, and those who received letters from 
him on his own private Italian watermarked stationery, 
in which his likeness is watermarked so perfectly, appreciate 



Letter Writing 207 

the tone and class of the man whose vocabulary has never 
been excelled on the American continent 

There is something about good stationery that lifts 
a man up, and if it is the best bond, or the best linen paper, 
with appropriate envelopes, there is something about the 
neatly typewritten sheet that makes one feel as if he were 
entertaining high ideals. 

When we receive a typewritten letter, where a number 
of words are misspelled, or the letteis blurred, it simply 
indicates that there is a letting down in the tone of the 
office. There is no excuse, at the present day, for poorly 
typed letters, or lack of distinctness in type. The machines 
put out today, both typewriters and mimeographs, are al- 
most perfect in their mechanism, and with a careful opera- 
tor everything should be absolutely neat and perfect. 



CHAPTER XXIV 



NEW PATIENTS 



(14) 



CHAPTER XXIV. 

NEW PATIENTS 

In this chapter we will deal in particular with the 
handling of new patients. 

I do not think any doctor should take all the cases 
that come to him for treatment. This immediately raises 
the question as to what kind of cases should be refused, 
and since osteopathy is such a wonderful therapy why 
should not a patient be given the benefit of the doubt, and 
the doctor at least attempt to do something for him? 

Suppose you go into a new place and establish your 
office and the first patient who comes is one that you will 
never be able to give more than slight benefit. If you take 
this case on for treatment, and after a few weeks' time 
you realize that he is not satisfied and that you have not 
made good, you have lost in that section of the town where 
he lives not only that patient, but possibly all of his friends. 

After taking four of these hopeless or unsatisfactory cases 
from four different parts of a town, you will possibly wonder 
in a year's time why you are getting ready to leave that 
town. 

The first patient I examined in Toronto I refused. It 
happened to be a case that would never be exactly satisfac- 
tory, from my standpoint Because of my refusing this case 
another member of the family came to me, and through it 
I secured a sufficient number to pay expenses in a very 
short time. I have made it a rule regardless of whether I 
am busy or not, absolutely to refuse to take a case if for 
any reason I feel that I should not do so. I contend that 
this is a physician's privilege, and in nine cases out of ten 
you will find that the patient will admire you for your frank- 

—211— 



212 Practical Visions 

ness, and you will be rewarded for your honesty in that the 
refused case will soon spread the news among his friends. 
When you stop to think of it, you are not, as a rule, the only 
physician in that town and if they want treatment of any 
description, there are others who will possibly be willing 
to take the case. It is not like the case of a doctor in a 
rural district where there is no other doctor for miles 
around. 

By keeping your practice within your control in that 
you feel that you can benefit every case you are treating, 
you are going to make greater headway not only for your- 
self, but for those who live in that community. Why 
should a doctor burden himself down with four or five 
almost hopeless cases, when through taking them on he is 
keeping persons who could be helped, from coming to his 
office? People will watch their neighbors, and they usually 
know when they are going to an osteopath. They are 
closely questioned as to improvement or lack of improve- 
ment and the friends of a case that is not improving will 
seldom venture to come to you unless the patient you have 
been treating will recommend you. 

In a frank manner I have stated the attitude assumed 
toward chronic cases that cannot be relieved to any great 
extent. You will want to know what kind of cases cannot 
be helped, and in brief, I will say that in every known disease 
from rheumatism to anemia, you will find cases that have 
reached a certain point where pathological changes are 
such that you will find it quite impossible to make restora- 
tion. There are also certain forms of paralysis, even paraly- 
sis agitans, also chorea as well as sclerosis that you might 
better leave alone. 

Later on, after you are well established, you can take 
these cases one by one and they will not hurt you as much 



New Patients 213 

if you feel from a humanitarian standpoint that you should 
give relief to every person that applies to you. But I prefer 
the long distance vision in which eventually I can reach the 
greatest number of people, and give the greatest amount of 
relief in the quickest possible time, and to my mind this 
can be done only by selecting your cases and giving them 
concentrated attention from a specific standpoint. 

There is nothing I have said in this chapter but what has 
worked out in actual practice, and while I refuse an oc- 
casional case for various reasons and while I also lose to 
some other practitioner an occasional case through giving, 
apparently, too specific a treatment, yet taking it all in all, 
I have found it possible to handle a tremendous practice, 
and to relieve, during the course of a year, as well as re- 
store to normal, a far greater number of persons than 
should I have adopted the older policy of ' 'giving a patient 
his money's worth," as so many refer to it. 

We have never given a chronic case a diagnosis on the 
same day we make the examination, and follow the same 
practice even in some acute cases. We are not referring 
here to emergency cases. After making all the various 
tests, palpating all of the various areas, taking into consid- 
eration the lymphatic diagnostic symptoms in the way of 
edematous areas, using the blood pressure machine and the 
stethoscope and testing the reflexes, we call for a specimen 
of urine for testing purposes and should an X-ray examina- 
tion be found necessary, we invariably refuse to give a 
diagnosis until we are satisfied as to the real condition. 
There may be pseudoankylosis or a sclerosis, or an extra rib 
accumulation, gall stones, forms of renal calculi or one of a 
number of other conditions that would cause a thoughtful 
physician to hesitate in giving his diagnosis and prognosis 
when he has been referred to by some person as the court of 
last resort. 



214 Practical Visions 

In one chapter we have emphasized alertnes and we 
again say that a doctor cannot be too careful in making an 
examination It is not always necessary to make all of the 
tests before treatment is begun, but we always wait at least 
twenty-four hours before giving our diagnosis and telling a 
patient whether we will take his case or not. We find this 
bit of anticipation very satisfactory in every respect. It also 
gives a chance for second thought, and I am of the opin- 
ion that it is well to weigh in your mind over night, or dur- 
ing the twenty-four hours, the case in its various aspects 
and figure out in your own mind whether you are justified 
in taking hold of that case and promising verbally or from 
any other standpoint, relief such as the patient thinks he is 
going to receive. 

It is just as well to have the impression go around 
that you will not take every case. The greatest institution 
in the Northwest has that reputation. They have worked 
on a certain basis for years and many are the cases that 
have been sent home from that famous place just for the 
reason that the physicians decided that they were not ab- 
solutely positive that it was wise to operate. 

When your new patient returns the next day for his 
diagnosis, tell him in a frank manner that you are delighted 
to take his case, and after due consideration and compar- 
ative notes, including the various tests made, you are reason- 
ably sure that it would be wise for him to take the treat- 
ment. When he asks how long it will take, don't quote 
months or years ; but realize that specific osteopath} 7, deals 
with weeks as a rule, and that if osteopathy can handle 
the case in three or four weeks' time, he will be satisfied to 
continue the treatment. 

If the case is of such a nature that you do not feel that 
you care to take it, tell him so. Also state that some other 
physician would possibly be perfectly willing to take the 



New Patients 215 

case, and might be able to handle it far better, in that he 
might have had more experience along that particular line. 
It will not hurt you to let a case go; it will do you good. How 
can any physician take hold of a case and give that pa- 
tient treatment when he is not clearly satisfied in his own 
mind that he will be able to restore that patient? That very 
thing will shake your own confidence, and you cannot 
afford to have it shaken. Do nothing that will tend to 
shake your confidence in handling any case, and you will 
eventually come to feel that should an occasional case, 
through some perverted pathological condition, fail to re- 
spond to your treatment, as other similar cases have done, 
you will know that you have given the patient the best 
attention that you possibly could and in all sincerity be 
true to yourself in handling cases, and your patients will 
realize it and admire you for it. 

When you have established a reputation of this kind, 
you will find that almost invariably your patients will 
smile in a joyous manner when you tell them that you will 
take them on for treatment. This is not psychology neces- 
sarily, it is plain straight Abraham Lincoln honesty. 

When you have on your list fifty, one hundred or one 
hundred and fifty patients coming every day or every other 
day, or even twice a week, and every patient assures you 
by his attitude that he has absolute confidence in you, 
then and there you are happy in your work and satisfied 
that you are doing all you possibly can, and at the same time 
you are desirous of doing more for them. It is a good 
atmosphere to live in. Be honest with your patients and 
give them the best you have. Let no day pass without 
thinking of the Founder of Osteopathy. He battled alone 
in the world, against all odds imaginable and he lived to 
see the day when his great scientific truths were implanted 
in the minds and hearts of millions of the American people. 



CHAPTER XXV 



TREATMENT ROOM 



CHAPTER XXV. 

TREATMENT ROOM 

Some time ago we wrote an article entitled, "How do 
you put in so much time in the treatment room?" We 
received a great number of letters regarding this particular 
article. We will refer to certain points of interest con- 
tained in that article and bring out some of the major points 
that will interest practitioners more, possibly than some of 
the minor points that need not be discussed in this chapter. 

Some doctors have the idea that they must converse 
with the patient after passing the time of day on entering 
the treatment room, and also ask the patient how he 
has been. This takes time. Possibly the doctor has 
plenty of time to spare, and some doctors may think that a 
nervous woman needs to be approached gently as we have 
a great many cases of neurasthenia. We have found in 
our practice, that first impressions are the strongest, 
and that in reality a patient likes to see his doctor work. 

We are in the habit of giving treatment without a 
coat. As soon as we enter the treatment room, the coat is 
hung up and we are ready for business. If a patient has 
the inclination to talk, our very attitude is against it in 
that we seem so busy, and proceed without asking the pa- 
tient any questions, and sometimes give a patient fully 
half of his treatment before saying a word. Now this 
does not imply that we are hurrying the case, or 
that we intend to give a short rapid treatment, but to me it 
means that whatever can be done from an osteopathic 
standpoint can and should be done in the quickest possible 
time. 

—219— 



220 Practical Visions 

There is something peculiar from a psychological stand- 
point iD the fact that as a rule a rapid treatment is of much 
more value to a patient than a slow, drawn out treatment. 
The other day I was taking a treatment and the doctor 
started to talk as soon as I entered the room, also continued 
talking as he took hold of my side to manipulate the muscles. 
His hands were cold and he seemed to have no particular 
vitality, although supposedly a strong man. Keeping on 
with the talking, he pulled away at the muscles, trying, ap- 
parently, to relax them and it was fully three or four minutes 
before he had gotten down to business. This made me 
nervous, and I believe you can make a patient more ner- 
vous by dilly-dallying and by too much verbosity than by 
taking hold of him with a firm hand and doing cor- 
rective work in a scientific manner. I do not jump at a 
patient, but I move rapidly, and my mind is so centered 
on what I am trying to accomplish, that the patient re- 
alizes that I have entered the room to give the best service 
possible in the necessary length of time. 

Strange it may seem when I state that if I had but one 
patient waiting in a treatment room and the other four 
were vacant, I would give the same quick specific treatment, 
and linger only sufficiently long to do my work. Patients 
like for you to take off your coat and get down to business. 
We have done it for years, and while the treatment is most 
specific, yet the patient feels that you are giving him your en- 
tire attention from a concentrated standpoint. For example, 
a lady came into the office today with her husband, complain- 
ing of a bad knee. In a moment's time she was lying down 
ready for attention. As soon as I took hold of the knee I 
found the cartilage slightly slipped. It took about ten seconds 
to replace it. I had her turn on her side and rotated the 
lumbar region, then on her face, and sprung both innomin- 



Treatment Room 221 

ates to determine the amount of mobility. 1 considered that 
sufficient treatment for one day. She jumped up and started 
to dance. Her husband told her she had better not do that 
on a weak knee and she refrained. The correction of one in- 
nominate and the replacing of the cartilage was quite suffi- 
cient. She had come only to have her knee fixed. That is 
specific osteopathy. She seemed in perfect health other- 
wise and only desired to have her knee fixed. 

The next case was a man who had fallen on his arm 
several months previously and the tendon of the biceps was 
out of the groove in the humerus. Remembering the Old 
Doctor's method of replacing this tendon, I gave the arm 
one swing and turned the thumb backward and outward, 
felt the tendon slip back into place and with one spring on 
the outer end of the clavicle the shoulder was again restored 
to normal. The man did not ask for general treatment. 
He simply wanted his shoulder relieved . There are cases like 
this that are practically emergency cases and it is not always 
necessary to give them a general systemic examination when 
they do not request it. 

In making a general examination we spare no pains in 
going into details. We have referred to this in another chap- 
ter, and we will confine ourselves in this chapter to the man- 
ner and method of approaching and treating patients, also 
leaving the room after treating a patient. 

Seldom does any case require more than ten minutes 
for treatment and many cases do not require more than two 
or three minutes. Had the osteopaths all over the world 
confined themselves to specific work, osteopathy would be 
in a position today that would command the attention of 
all peoples. There may be a possibility that lack of train- 
ing in the colleges has had something to do with the great 
length of time put in in the treatment room, but we are in- 



222 Practical Visions 

clined to lay the blame on the doctor. His lack of 
confidence in himself and his desire to give his patient his 
money's worth, so to speak, and to impress the patient 
with the idea that he is thorough and painstaking, so that 
he will be able better to hold them, has had to do with the 
lengthy treatments that are quite universally given. 

We take this attitude and as it works out in a charming 
manner we have no desire to change. Our attitude has 
already been outlined in that we are inclined to believe that 
the patient wants speedy relief, and the more specific 
the work you perform, the greater the impression you make 
on the patient. Likewise a patient is always perfectly will- 
ing and anxious to be relieved of his trouble in the quickest 
possible time. 

In the instances referred to above, along the emergency 
line, examination and treatment all together occupied less 
than five minutes' time. In order to be able to do this 
specific work and to be satisfied in your own mind that you 
are able to diagnose and do the corrective work from an 
absolutely mechanical standpoint, you must train your mind 
along that particular line. This can very readily be done 
and with no fear of losing your patients, you can give them 
ease from pain or freedom of motion in their various joints, 
in many instances in a very short period. 

The other day we had a man to come in who had lifted a 
large ash can and produced a lumbar lesion. He simply 
wanted relief in the quickest possible manner as he had to 
drive a number of miles that day and did not want to wait 
very long. We placed him on his back, measured his feet, 
examined the hips, turned him on the right side, gave one 
single rotation in the lumbar region locking the vertebrae 
in a manner so as to concentrate force upon the lesioned area, 
and with this one single rotation we realized that the correc- 



Treatment Room 223 

tion was made, and told him that was sufficient for this 
time ; if it bothered him again to come in. He drove over 
one hundred miles that day, and has had no further discom- 
fort, and we have treated two members of his family since. 

What I am trying to impress on the young practitioner 
is this, that specific treatment will enable him to handle 
practice and increase his practice far better than the long 
drawn out muscle kneading treatments in which one might 
just as well write out on a piece of paper, " We aim to please 
and give you your money's worth." The attitude of a 
physician should be this: One of extreme confidence backed 
by ability and an earnest desire to accomplish the greatest 
amount in the least possible time. 

Picture in your mind, if you are practising in a large city, 
the great throngs who are suffering and are disabled in 
some respect. Say to yourself : There are at least five thou- 
sand persons in this city this morning who need osteopathic 
treatment. "I cannot treat them all, only a fraction of them, 
but I will give relief to as many as I possibly can, and they 
will bring others. In time I will reach a great many of the 
five thousand." 

With this particular viewpoint in mind you will be able 
to accomplish a great deal more when you realize that you 
cannot treat more than seventy-five or eighty-five in one 
day. The remaining four thousand plus will have to go 
on suffering, or secure relief by other methods, or possibly 
be handled by fellow practitioners. 

There is no excuse for not having a tremendous prac- 
tice in a large city, as there is any amount of work to be done, 
and if you want the people back of you and in sympathy with 
you, keep your clinics going. Show the people you are just 
as willing to treat children of poor parents as those 
of the rich people. After all, the anatomy of the human 



224 Practical Visions 

body is practically the same in every human being. A 
pain is a pain the world around. Sciatica is sciatica whether 
it is in the Chinaman or Anglo-Saxon. Rheumatism affects 
every known race and neuritis has been found in every clime. 

Suppose you have a patient who is talkative, always 
asking questions, wants to know this, that and the other. 
Let me tell you how to handle him. In some instances one 
will ask whether talking bothers you. Invariably say 
" Yes", and that you will answer any questions after you get 
through with the treatment. If he insists on talking, give 
a little extra force on some lesioned area, and ask 
if that point is sensitive. If that does not stop him, 
put him on his face immediately and spring the innom- 
inates, or rock the sacrum. 

A physician should never discuss politics, religion or 
gossip. If they ask you your religion, tell them you are 
an osteopath; or politics, tell them the same; and what paper 
you read, tell them you take all the papers, which we have 
done, by the way, for years. If they ask regarding some 
disease, tell them you will have the nurse hand them 
a booklet when they leave the room. Always be on the alert, 
head them off to keep them from talking and, of course, do 
very little yourself. Go into the treatment room as if you 
were determined to restore them immediately, also make 
each one feel as if his case was the only case you were handling, 
or at least, you were as much interested in his case as a 
physician possibly could be. 

It is absolutely necessary to have sufficient rest and sleep 
to keep in mind what the patient has told you at some pre- 
vious date. And there are those who will try to corner you 
and see if your latest diagnosis corresponds with your first 
diagnosis. Alertness is one of the greatest factors in a 
physician's make-up. 



Treatment Room 225 

Each treatment room should contain the latest maga- 
zines and a few books. Let no magazines remain in a room 
that are not current numbers, and take a sufficient number 
to show that you are broad-minded. 

Each room should contain a fan, an electric heater 
for chilly days, and a large steamer rug. 

It is a mistake to have a patient use a treatment room 
for a rest room. Invariably tell lady patients to go straight 
home and rest for an hour, lying on the back or in a comfort- 
able position. We do not let them go shopping, and we do 
not encourage their remaining at the office for any length 
of time, and seldom do we have any one lingering unless 
it be one who has come to the office in a run-down and de- 
pleted condition, to the extent that he needs to rest five or ten 
minutes before starting for home. 

By giving short specific treatments, you will not tire 
a patient to any extent, and as a rule, the patient will be 
refreshed. Keep the treatment room for patients to come 
to have their treatment, and go out as promptly as possible, 
so that others also may have a chance. 



(15) 



CHAPTER XXVI 



ADVERTISING 



CHAPTER XXVI. 

ADVERTISING 

Without any doubt, it always pays to advertise. Of 
course, a physician must advertise in an ethical manner, 
and that consists, briefly, of using chiefly the literature pub- 
lished by some of our progressive osteopaths who are in- 
clined in that direction. 

I am a great believer in educating the public, and I 
would use the word " advertising" advisedly, as no physi- 
cian cares to refer to his propaganda work as an advertising 
proposition. 

To rely upon the sending out of osteopathic literature 
as the principal means of creating and maintaining a prac- 
tice is absolutely the wrong idea; but sending out a reason- 
able amount, at regular intervals, is usually a very wise 
idea. If you send out too great an amount at one time, 
people will think you are in need of practice; and if you 
send out no literature for a period of time they think you 
are going to leave town. They will not think of it as being 
due to the fact that you are so busy that you do not want 
any more patients for a while. They will simply conclude 
that you are either not interested, or that you cannot afford 
to carry on a publicity campaign. 

Personally, we use more of the Osteopathic Magazine 
than any other publication. There is no doubt in the world 
but that the booklets, leaflets and brochures published by 
my old classmate, Harry Bunting, also those by the great 
publisher of the Mississippi Valley, R. H. Williams, are 
exceptionally good, and we also use a great deal of both kinds. 
Then there are special booklets and brochures published 

—229— 



230 Practical Visions 

elsewhere that are also of great merit; but the main point is 
to place reading matter in the hands of those who are inter- 
ested, or who are taking osteopathic treatment, and not 
to send out a promiscuous list to every one and expect that 
you are going to get great results. Personally, we have 
not for many years sent out any literature except at the re- 
quest of some patient. Two or three hundred copies of a 
special number mailed out to those whom you know will 
use them to good advantage, is certainly of greater value 
than spasmodic attempts to reach all of those in the phone 
book one month and the Blue Book another month. 

We certainly believe there are a lot of osteopaths who 
do not send out sufficient literature. There are very few 
who send out too much. We are inclined to believe that 
the sending out of more literature will help to educate the 
people so that they will become sufficiently interested in 
osteopathy to recommend it to their friends, as well as keep 
up occasional treatment on their own part. 

It is a mistake to try to put out your own literature 
when there are those who have given it a lifetime of study 
and can select the very best material from various sources. 
Almost every one has had the experience of feeling at times 
that he would like to write a certain article, or put out a 
certain piece of literature that would hit the nail on the head; 
but if you will look very carefully over the various pieces of 
literature that have been published, or write to the pub- 
lishers and ask them for a list, you will soon realize that 
very few of the basic points in osteopathy have not been 
treated at some time or other. 

While it is very well to circulate a reasonable amount 
of literature regularly (that is, at least ten months in the 
year) we are inclined to believe that the greatest publicity 
that any physician can receive, without exception, comes 



Advertising 231 

from so conducting his practice and securing results through 
specific adjustment, that his patients will talk for him at 
all times. When you get fifty or seventy-five persons putting 
in a good word for you at various social gatherings, after- 
noon tea-parties, evening dances, and after-church inter- 
views, then you will find that you have working for you, 
people whose services you could never pay for, and to whom 
no one would listen but those who knew them; and event- 
ually, when new patients come into your office, they will 
say that they were referred by "so and so," who, in turn, 
had taken previous treatment through hearing of some one 
else who had been cured; also through reading osteopathic 
literature. 

It is in this way that we get the majority of cases from 
year to year. Literature well-placed in the hands of those 
who have been benefited by osteopathy, will do more good 
than ten times that amount of literature promiscuously 
placed. 

Be sure to keep a very carefully selected list of those 
who you know will receive the literature you send to them 
and use it to the very best of advantage. 

The publicity campaign question is quite a serious one, 
and all kinds of phases present themselves; in fact, the mat- 
ter has never been satisfactorily settled as yet, and possibly 
never will be. It is just a question of going about it in the 
most ethical manner possible, and getting results in a way 
that will not be offensive to the public as a whole. 

Each man has his own idea of advertising. Some think 
that they need not advertise at all if they do the good work. 
That is rather a selfish motive, as no matter how large a 
practice may be, even if one be turning patients away, for 
the sake of osteopathy in general and the assisting of those 
who are less busy, it is necessary that we carry on a systemat- 



232 Practical Visions 

ic campaign to educate the people as to the true principles 
of osteopathy. 

The people are not so well-posted but that you will find 
in your own practice, for instance, that certain patients will 
ask you regarding a certain disease, and say, "Well, I didn't 
know that osteopathy could handle that disease, or I would 
not have advised my son to go to a specialist to have his 
trouble treated." We hear this every day, and it will be 
many years yet before the people will become so familiar 
with osteopathic truths that they will not need to be edu- 
cated toward a viewpoint more satisfactory to those who 
are trying to familiarize the public with osteopathic princi- 
ples. 

It is true that the medical profession does not have to 
advertise in an open manner, but the greatest publicity 
campaign known is carried on day by day, month by month, 
and year by year, in a manner that does not, in any way, 
have the appearance of being advertising matter. The 
papers and magazines almost monthly, and the dailies, 
daily, contain from one to three or four articles directly 
or indirectly discussing some health matter, or some disease, 
under a special column, or mentioning some epidemic where 
certain serums have been found to relieve certain condi- 
tions; and by the end of the year, you will find the sum total 
of this insidious publicity campaign work will amount to 
sufficient material in any one locality to make a good sized 
volume. 

We have not yet reached the stage where we can get 
the ear of the press, but we will some day, and until we can 
do that, it is up to us to use the best literature published, 
and, in an ethical manner, secure the attention of those who 
either are taking treatment or will eventually be interested 
in osteopathy. 



Advertising 233 

It will be just as well to circulate magazines from var- 
ious publishers at different times. For instance, a couple 
of hundred osteopathic magazines, put out by the A. O. A., 
one month; and the 0. H., or Williams' brochures, another 
month; and that most stable magazine, the Herald of Os- 
etopathy, which is one of the oldest osteopathic publications 
and which has brought thousands of new patients to the 
osteopaths' offices. 

Each doctor can select his own reading matter, but never 
think that you are doing the right thing until you have used 
a certain amount, at least, of publications that explain the 
principles of osteopathy from various standpoints. 



CHAPTER XXVII 



RESEARCH 



CHAPTER XXVII. 

RESEARCH 

There is something fascinating about research work. 
Those of you who have seen that famous play "The Bird of 
Paradise" will remember distinctly the tremendous feature 
in one of the scenes wherein a graduate medical doctor sup- 
posedly finds, from a microscopical viewpoint, the causa- 
tive factor of leprosy. 

To my mind there is no greater point of interest in any 
physician's life, outside that of a grateful patient, than the 
inventive or research turn of mind in making an entirely 
new discovery, whether it be a causative factor, or technic, 
administration of instruments or a formula that is useful 
to a patient undergoing operation or treatment. 

We have always felt that every physician in actual 
practice, should at some time during each year, accomplish 
at least one thing along the line of research work; and this 
would be possible, in almost every instance, if physicians 
would realize that research development takes place only 
after one has concentrated sufficiently on a particular sub- 
ject. 

Inventions, as a rule, do not come out of the blue sky. 
We may be inspired by Nature's wonderful touches, and 
it is quite possible to live so in tune with Nature that we 
can practically draw out of our observations while in touch 
with Nature, unusual and remarkable thoughts and possibly 
discoveries; but the greater number of inventions and the 
greater amount of research work accomplished in the labora- 
tories, follows only a tremendous amount of study and 
detail work. 

—237— 



238 Practical Visions 

It does seem to me that it is worth while to try and 
reach a point where we can touch these two most satisfactory 
phases in a physician's practice. If there are certain propo- 
sitions to be handled, and certain goals to be reached in 
order that we may receive that unusual stimulation that 
goes with touching the goal, or reaching the highest point of 
success, in the way of research findings, why not set out to 
attain this high and unusual point of vantage? 

If every graduate of an osteopathic college would follow 
out the resolutions that he made while attending college, 
it would not be very long before he would have a thesis 
written on some particular disease that had attracted his 
attention and to which he had devoted weeks and months 
of constant consideration and thought. While this treatise 
might not be anything particularly new, yet it would be the 
beginning of a great ending, and I absolutely believe that 
any physician who will start out in this manner (taking for 
granted that he is sufficiently interested in any one sub- 
ject) and work through to an end, will within ten years' 
time, develop some new idea and make himself almost a 
specialist on that particular line of work. 

You seldom, if ever, hear of a specalist on varicose veins, 
for instance, yet back of that tremendous physiological per- 
version there is room for a specialist to make himself famous 
the world over. There should be a way of handling vari- 
cosities, although possibly indirectly, from a vasomotor 
standpoint, in the early stages, and later on from a more 
or less mechanical standpoint, to the extent that the phy- 
sician will be able to advise, in almost every instance, a 
successful method of handling this peculiar, annoying con- 
dition. 

Seldom do we find a specialist who has devoted his 
entire time and energy to the subject of phlebitis, yet there 



Research 



239 



is a direct cause in almost every instance, and there should 
be a specific treatment. While we have, in a general way, 
considered both of these conditions from an osteopathic 
viewpoint, and while, in a general way, our books cover these 
two diseases from a technical standpoint, yet we have never 
followed through sufficiently to bring out scientific details 
to the extent that we can advise minutely the administra- 
tion of treatment in each and every instance. 

We might go on through all of the various diseases and 
show that those who specialize follow a certain routine. The 
majority of specialists take up one of ten diseases, and every 
one is sufficiently familiar with these that we need not name 
them. About the first thing a student has in mind when 
graduating is to specialize along the line of eye, ear, nose 
and throat work. This seems a very inviting field. If he 
is not so inclined, he may make a specialty of surgery. Or 
he will specialize on genito-urinary troubles, while some 
of the lady osteopaths will specialize on obstetrics. 

Few of our osteopaths venture to specialize, for instance, 
on nephritis, yet in ten years' time, by concentrated effort 
and research work along the line that osteopathy indicates, it 
would make a man famous from coast to coast. 

How many of our osteopaths have specialized on goi- 
ter, for instance, and are known throughout the osteopathic 
profession as goiter specialists? 

How many have concentrated their entire time and 
energy on hepatic disturbances, or even splenic disturb- 
ances? 

There is absolutely room for specialists along these 
various lines, but in order to get out of the ordinary routine, 
research work is demanded and the majority of our grad- 
uates are not research men — the vast majority, I say. About 
one in a hundred has a tendency towards research develop- 



240 Practical Visions 

ment, and they follow the lines of least resistance. They 
buy all of the books published, and visit the reference li- 
braries to post up on the specialty of eye, ear, nose and 
throat work. This may be one of the most fascinating 
callings, but it is covering the ground that might be done 
by those who have no inclination along research lines. 

However, in our osteopathic field, I am glad to say that 
we have the greatest eye, ear, nose and throat men the world 
has ever known. The names of some of our osteopathic 
specialists in this particular line will go down in history as 
inventors of the most ingenious methods ever conceived by 
physicians. 

We are just reaching the threshold of a great awakening 
along the line of research work. I have contended for years 
that the osteopathic profession, represented by our National 
Association, could pull off no greater piece of work some one 
year, than that of a research year. We have some splendid 
research workers, who have been at this line of work for 
many years, and we have some splendid laboratories; but 
how few are doing the actual work! We want to dip down 
into the colleges, reaching the various students, and creating 
in their minds, through the teaching of the professors, that 
peculiar research instinct as a result of which a student will 
so thoroughly ground himself in the idea of being original 
that when he is graduated and goes out into the field, he 
will have an awakening that will result in findings that were 
never dreamed of before the research idea dawned upon 
his mind. 

If we are going to devote our entire lifetime to the 
therapeutic art, and if we intend to put our whole soul and 
energy into the work, which we should do in order to make 
a success of it, I am sure that there are sufficient hours in 
the twenty-four to devote at least a few thoughts to research, 



Research 241 

and turn our attention to some particular phase, hoping 
that some day, out of our study and concentrated thought, we 
will produce something that is worth while to humanity. 

How is the world going to progress from a therapeutical 
standpoint, unless the individual doctor will arouse himself 
and become sufficiently interested in the physical welfare 
of humanity to throw his energy into his work sufficiently 
to bring about, or develop, the creative turn of his mind, 
whereby he will get away from the beaten path, and, with 
a more thorough knowledge of the workings of the human 
body, bring out some feature that has never been known 
before in therapeutic history. 

We will welcome the day when there will be more re- 
search men, and when each doctor either will do research 
work, or it will be known that he is not interested in it. 

We hope there will be sufficient interest in this line that 
patients coming to a physician will ask him from year to 
year what he has done new for humanity. This will indi- 
cate how much interest he is taking in his work, and how 
much time and attention he has devoted to that particular 
phase, wherein something new will be turned out that will 
be of value to suffering humanity. 

There are some physicians who devote a great deal of 
time and energy to speculative measures, or to the social 
side of life. There are others who are over-studious, but 
they are in the minority. 

The well-rounded physician, who attains sufficient 
heights to be known as an outstanding physician, or sur- 
geon, is the one who has burned the midnight oil and who 
knows and realizes that he is accomplishing something that 
is unusual. 



(16) 



CHAPTER XXVIII 



TREATING CHILDREN 



CHAPTER XXVIII. 

TREATING CHILDREN 

Some doctors like to treat children, others do not. 
I must admit candidly that I practised for about fifteen 
years before I really enjoyed treating a child. In fact I 
have turned away many a child because it cried when being 
examined, and I just did not want to bother handling that 
child as it seemed to make me nervous. For some unknown 
reason I changed about entirely, and at the present time 
it is more pleasure in almost every instance to treat a child 
than an adult. I have a great fondness for children; I 
dislike seeing them handicapped physically and I thoroughly 
enjoy seeing them restored to health. 

When I became interested in infantile paralysis, I 
realized that in order to test out the merits of osteopathy 
in these cases, it would be almost absolute^ essential to 
conduct a free clinic in that we could hold the cases for the 
necessary length of time in order to bring about the restora- 
tion. From this reasoning the National League for the 
Prevention of Spinal Curvature was founded, and through 
it a great many clinics have been established over the coun- 
try, and thousands of children are being benefited each year 
and likewise the doctors have benefited by the experience, 
and have almost invariably more faith in the science of os- 
teopathy. 

We also found that another reason we did not get good 
results in treating children, was not only that we had not 
been treating them for a sufficient length of time in infan- 
tile paralysis cases, but that we had not been giving them 
proper adjustment. Because they were children we had 

—245— 



246 Practical Visions 

the idea that we should amuse them, tell them stories, count 
their toes, knead their muscles and do very little real cor- 
rective work. 

In our great clinic where we treat as many as forty- 
eight children in one hour and twenty minutes, we give them 
not only specific treatment, but use a great deal of force 
in thoroughly springing and securing motion in the verte- 
brae in the various regions. We did not think at first that 
it was necessary to secure a strong lumbar rotation as well 
as good motion in the lower thoracic, but we have found 
that a good stiff treatment is quite essential if we desire 
to secure vasomotor tone, and bring back to a normal con- 
dition the atrophied muscles in the legs especially. 

Massage will bring about sufficient effect on the circu- 
lation to warm the feet temporarily, but in half an hour's 
time the feet will turn cold again. After two or three spe- 
cific treatments, we can throw the circulation to the feet 
that were once cold and clammy and make them warm for 
at least several hours. After two or three weeks' treatment, 
the mothers will remark about how warm the feet are in 
contrast to their being so cold over a period of time extend- 
ing back to the convalescent stage when the child was 
slowly recovering from the attack. 

We likewise give a thorough adjustive treatment in 
the cervical as well in the upper thoracic, and should there 
be muscle atrophy in one or both arms, there seems to be 
a necessity of a strong specific treatment in the region just 
referred to. Children will not break, and if you are well 
posted in your technic, you will not injure them, but you 
will start impulses' in the various nerve tracts that will 
awaken the various circulations and bring about a physio- 
logical activity that will make restoration possible in the 
majority of instances. 



Treating Children 247 

If you have no particular fondness for children, and they 
will not go to you with confidence, you are absolutely ex- 
cused from trying to handle these cases, but if you can 
win the confidence of a child in a very short time, by all 
means take great interest in the children. It is all well 
and good to treat old chronic cases, give them ease or re- 
store them in the great majority of instances, but is it not 
true that the children should be reached and brought back 
to normality just as much as the adults, if not more so? 

Were it possible to eradicate all cases of scoliosis by 
semi-annual inspection and adjustment, it would be but 
a few years before we would have but few chronic cases in 
adults to bring back to normal. What a different world 
this would be if the osteopaths could carry on this special 
semi-annual work and train the children in such a manner 
that whatever ailment came upon them later on in life, they 
would have speedy adjustment and quick restoration. 

We are keenly interested in clinics. We cannot under- 
stand why any osteopath living should not either have a 
personal clinic or work in a group clinic. It seems to me 
that it is the duty of every osteopath to carry on in some 
clinic. There are a number of osteopaths who will say that 
they treat children free occasionally during the week, but 
in these instances no particular credit is given such as might 
be should a clinic be announced and the mothers of the 
neighborhood have their attention drawn to the fact that 
a clinic is really being conducted, and that other children 
are welcome, and that the doctor is known as one who is 
willing to work in a clinic without remuneration. 

It is this concentrated action that not only benefits 
those that are being treated, but also gives a backing to os- 
teopaths that cannot be equalled in any other respect. When 
you once have the mothers of a neighborhood or in a town 



248 Practical Visions 

talking for you, you are accomplishing something that will 
last for years. Cases will be sought out by these interested 
mothers, where parents are unable to pay for treatment, and 
you will be surprised at the keen interest these mothers take 
in bringing in a neighbor's children to have them brought 
back to normal. 

We hope that in the next few years the osteopaths all 
over the land will have established not only one hundred and 
sixty clinics as there are at the present time, but two or three 
thousand clinics. When this is accomplished, we will point 
with pride to what osteopathy is doing all over the land, and 
we will have a better class of people physically, and the world 
will move more smoothly because we have done our bit. 

It takes time to treat a case of infantile paralysis where 
a child has been wearing a brace, or going about on crutches, 
or has been in a cast for some length of time and possibly 
undergone an orthopedic operation on the tendo achilles, 
but it is certainly amazing to see the results that may be ob- 
tained if we are sufficiently persistent and interested in 
the children's welfare. It may take six months, or possibly 
a year, but I will frankly state that I have treated these cases 
two years in the free clinic and have been almost invariably 
rewarded by observing that the child was again almost nor- 
mal in every respect. Ninety percent of these cases can be 
restored if they are not too chronic; the other ten per cent 
can be benefited. 

I have never as yet seen a case of infantile paralysis that 
could not be benefited by osteopathy. If the time ever 
comes when we will be allowed to take the acute cases, there 
will be so few cripples in this land that we will simply be 
amazed. Unfortunately, there are those who think that 
other methods than manipulative are the proper thing in 
the acute stages. The few cases that we have been able to 



Treating Children 249 

handle in one way or another while in the acute stage, have 
proven to us most conclusively that the greatest treatment 
in the world for acute conditions is specific osteopathic meas- 
ures. 

A two-minute adjustment will reduce the fever even 
in an infantile paralysis case, and the child that has been 
tossing on its bed and contorting itself in that feverd condi- 
tion will He quietly and sleep for at least short intervals, and 
in two or three days' time through the absence of the ex- 
cessively high fever, very little damage will have been done 
to the motor areas of the spinal cord. The old idea of allow- 
ing these cord segments to burn out and then stating that 
there is no possibility of restoration because they have burn- 
ed out, is most fallacious to say the least. The most impor- 
tant time to check this great destruction is undoubtedly at 
the time when the fevered condition can be controlled. 
Were we not familiar with specific nerve centers, and did we 
not understand how these centers control the circulation 
over the body, we would be entirely unable to secure any 
results. 

Massage is absolutely contra-indicated in these early 
stages, as the three circulations should not be churned up, 
but if specific adjustment could last but half a minute or 
even a quarter of a minute, regulating the nerve impulses, 
it may save the child from years of suffering and restore it to 
normal health. 

Pay more attention to the children; learn how to get 
their confidence and give them stronger treatments with 
less muscle kneading, and you will be pleased with the re- 
sults you get, and the clinic that you will start, if you have 
not already entered into one, will add to your pleasure as a 
physician, and at the close of each year you will feel that you 
have done something for humanity that will live after you. 



CHAPTER XXIX 



OFFICE ATTENDANTS 



CHAPTER XXIX. 

OFFICE ATTENDANTS 

There are a few very important points which concern 
every practitioner, and one of the chief of these is the selec- 
tion of the attendants in his office. 

We have taken for granted that you have selected a 
most desirable suite of office rooms in the down town dis- 
trict, and that you desire to make the proper impression 
upon your patients as they enter and leave your office; 
also that you consider from a business standpoint as well, 
the value of proper attendants. 

First, there is no question in my mind but that a grad- 
uate nurse is of more value to an office than the average 
physician would naturally think. We have had in our 
office continually for fifteen years, a graduate nurse. She 
has always been dressed in uniform. There is something 
about the presence of a nurse that inspires confidence in 
your lady patients, and if you have selected well, you will 
find that there are a great many things that the nurse can 
answer, thus relieving you of a number of the lesser duties. 
For instance, a graduate nurse is supposed to be well posted 
on the subject of diet, the giving of enemas, douches, and 
a number of minor points which are so valuable to the in- 
quiring patient. 

If the nurse is of the right sort, she wiJl make friends 
with the lady patients, who will ask her many questions, 
and she will be able to give them the desired information. 
Suppose a case is being treated that has been used to the 
taking of laxatives, and a more natural substitute could be 
given, I find it well to give a simple bit of instruction to 

—253— 



254 Practical Visions 

the nurse as to how to prepare some food that acts as a 
laxative, or how to mix bran so that it will have the desired 
effect upon the alimentary tract, also the proper way to 
take an enema, the use of the high colon tube for high ene- 
mas and the antiseptic solutions used in douches. These, 
and a great number of other things which she will describe 
to the patients, relieve me of that amount of detail. 

Suppose you open an office in a small town of say five 
thousand. You will ask if I would recommend a nurse in 
that instance. By all means I would, even if it is a place 
of only two thousand. A nurse will give tone to your office 
more than you can imagine. She will be part of the office 
staff and the intelligent replies that she will give over the 
phone to questions pertaining to periods and so forth, 
can all be very nicely handled and with that delicacy that 
goes with proper training and understanding. 

Depending on the size of your practice, the number of 
attendants may be regulated according to the amount of 
work that is to be done. Appointments must be made and 
the nurse must understand your capacity to handle patients 
according to their various ailments. We use no regularity 
in the length of treatment. Each case is individual in it- 
self. When she becomes accustomed to your methods of 
handling cases and understands that you can handle more 
cases on certain days than on others, and that certain cases 
need less time than others, you will find that her co-opera- 
tion will greatly assist you in determining just how much 
you can accomplish. 

If there is a great deal of letter writing to be done and 
if you acquire the habit of contributing to one or more jour- 
nals, you will necessarily have to employ a stenographer 
more or less continuously. If you do a great deal of work, 
you may need two, but all letters should be answered the 



Office Attendants 255 

same day they are received and all letters should be type- 
written. It is an imposition to expect a busy doctor to 
wade through a longhand letter and reply to it on the same 
day. A neatly typed letter is usually a pleasure to read, 
and likewise calls for a similar response. 

The nurse can handle the greater amount of the work; 
she can likewise look after the collecting of the fees. It 
is certainly easier not to keep books or run accounts, and 
to run your business on a cash system. There is all the 
difference in the world at the end of the year between a 
practically clean sheet in one instance and a loaded, doubt- 
ful, sheet in another. Have your patients pay at the time 
of each treatment and you will find, as a rule, it is much 
more satisfactory. 

Regarding appointment sheets: When we first entered 
practice we used the ordinary blank that is used by the 
majority, and as nearly as I remember, appointments were 
thirty minutes apart. I believe at the present time they 
have sheets that provide for fifteen minute treatments. 
We started printing our own appointment sheets. The first 
contained about twenty a day and the second about forty, 
and several years ago we worked out a sheet that contained 
a little over sixty a day. We have now abandoned the ap- 
pointment sheet entirely. We find there is a little psychol- 
ogy about a doctor's office as well as about a business man's 
house. 

There are times when everybody wants to come at the 
same time and it seems as if everybody wants to come that 
very same day. Here is where a level headed nurse will be 
able to assist greatly in equalizing matters by using her 
rare judgment regarding psychological propositions. It 
may mean that the doctor will have to be a little more alert, 
a little more active and expend a bit more energy for that 



256 Practical Visions 

particular day. If you have at least five treatment rooms, 
you can handle a goodly number and by a little tact you 
can treat those who are in the greatest hurry, Here is 
another advantage in giving specific treatment. There 
are some cases that will take only two minutes, while others 
require six minutes and occasionally a case may take ten. 

We will pause here for a minute and answer a question 
that is so frequently asked. How can you handle a chronic 
case that has a great variety of symptoms, and diseased 
organs, and give a treatment that lasts but a few minutes? 
This will bring up the great lymphatic proposition again, 
and in brief, we would state that the more complicated the 
case, the more specific the treatment should be. For ex- 
ample, we will take a case of inflammatory rheumatism, 
where the patient is so extremely sensitive that it is almost 
impossible to handle extremities, for instance, without 
causing a great deal of pain. 

Years ago I remember of trying to give a most general 
treatment in these particular cases, and I found that the 
treatment was almost more than the patient could stand. 
I got to reasoning along the line of bodily functionings and 
eventually it dawned upon my mind that in giving general 
treatment, I was churning the entire fluids of the body un- 
duly. I found that where treatment could be given only 
once or twice a week, by giving specific treatment according 
to the edematous areas found, I could get much better 
results, secure better drainage and get my patient out in 
much quicker time. Where there seemed to be a great deal 
of inflammation in the lower extremities, for instance, I 
would confine my first two or three treatments to springing 
the lower thoracic and lumbar region with the patient on his 
back, reaching over the body, catching the spinous pro- 
cesses with the tips of the fingers and springing forcibly 



Office Attendants 257 

upward. If there seemed to be any blockage in the terminal 
lymphatic ducts, a specific upper thoracic adjustment, and 
forcible springing of the outer ends of the clavicles, would 
relieve the condition sufficiently. The fluids of the body 
would become more or less equalized as the kidneys became 
more active and the terminal drainage more perfect. 

Why give a general treatment in these conditions when 
a specific treatment will be of more benefit and not tax the 
patient to the same extent? There are many other diseases 
wherein various organs are affected, and we would likewise 
advise specific adjustment in order to restore the condition 
to normal in the shortest possible time. 

It takes years to figure out this one proposition, and 
had I known this very point when I first began practising, 
I might have saved myself a great deal of trouble and anxiety, 
and at the same time have been of more benefit to the 
patients under my care. 

We cannot expect a young graduate to have had the 
experience that a doctor who has been practising for a decade 
or more has, but there is such a thing as profiting by the 
experience of others, and the majority of doctors are per- 
fectly willing to be advised and instructed, and after all, 
the greatest proposition in osteopathy is how to handle your 
patient in a manner that will enable you to secure the quick- 
est possible results. 

After practising almost twenty-three years, I am still 
learning something each day and my work is becoming 
more specific from time to time in that I feel that I can 
accomplish more and secure better results by following more 
closely the teachings of Dr. A. T. Still. When I think how a 
man could put before the world a new science, and give to 
his students details as he did regarding the various points 
that have been discussed in this and other chapters, I am 

(17) 



258 Practical Visions 

simply amazed at the resourcefulness of this blazer of a 
new trail. 

It has taken me many years to learn things that I re- 
member distinctly hearing the Old Doctor state, but at the 
time did not appreciate. We seemed to think at the time 
he was talking, that his peculiar way of doing things could 
not be applied to ours, and had I the privilege of living over 
those days and listening to him again, knowing what I 
do now, I should assume an entirely different attitude, and 
I believe that I should accept what he said and put it into 
immediate practice. 

True it is that all students going through college listen 
to the same lectures, watch the same clinical demonstra- 
tions and have in mind, apparently, the various nerve 
centers that control the functionings of the human body. 
But it is a different proposition entirely to be out in the 
field, thrown upon your own resources and confronted with 
a case of typhoid fever. For instance, try to put into prac- 
tice what you have been taught regarding adjustment and 
the control of the various parts of the body through nerve 
centers, that were outlined in the lecture room. 

I know personally of two juniors spending their holi- 
days years ago in a small town where an osteopath was taken 
down with typhoid fever. His temperature was high and 
apparently it was a typical case; all symptoms were mani- 
fested. These two students had great confidence. They 
were reasonably sure that they could control the fever in 
a very short time. They had listened to lectures regard- 
ing the reduction of fever in a quarter of an hour or less, and 
immediately they began working on the vasomotor nerve 
centers that would supposedly reduce the fever. After 
working some two or three hours intermittently, they real- 
ized that they were making no headway. No other grad- 



Office Attendants 259 

uate osteopath was within one hundred miles. They felt 
their helplessness and called in an old school physician and 
the usual drugs were given to reduce the fever. It still did 
not abate. 

The wife of the osteopath sent a messenger personally 
the hundred miles and presented the case to an osteopath, 
who, by the way, was an extremely busy one, and with that 
magnanimous spirit that the majority of physicians have, 
or should possess, this doctor took the first train and arrived 
within two or three hours' time after the interview. 

Within five minutes after his specific adjustment, the 
temperature began to drop. He had corrected a most 
specific lesion which the students had overlooked. They 
were depending more upon inhibition, as we used to call 
it, and manipulation of the muscles. 

The five minutes' treatment that this doctor gave in a 
most specific manner, changed the entire course of the ail- 
ment, and the result was that the patient was up and around 
in a little over three weeks' time; otherwise, had the tem- 
perature remained high for a few hours longer, there might 
have resulted a toxic condition that would have caused the 
patient to remain more or less convalescent four or five weeks 
after the fever was at its highest. 

This brings out the idea that we have stated elsewhere, 
that no short course in anatomy, physiology, pathology and 
so forth is sufficient for any man in handling the various 
ailments of the human body. Likewise, we cannot expect 
of a senior what we would expect of a graduate, and we 
cannot expect of a new graduate what we might expect of 
a man who has been practising ten years or more. How- 
ever, there are new graduates who are more capable of 
handling cases than some practitioners who have been out 
in the field ten years. It is all in the man, his vision and his 



260 Practical Visions 

peculiar understanding of the human body from a mechan- 
ical standpoint. 

There are many points of advice to be given to patients 
each day; there are many questions to be answered regard- 
ing osteopathy and the various diseases that we are supposed 
to handle and there are times when a patient would like to 
ask regarding some other member of the family Where you 
have free clinics, you will find the mothers asking many 
more questions regarding the health and care of their little 
ones. 

The nurse's attention is given free as well as that of 
the doctor. We have never made any charges yet in the 
free clinic. We give them every attention that we do our 
best pay patients, and every consideration is shown the 
mothers that is shown the wealthiest patrons we have. 
The nurse dresses in uniform for the clinics the same as she 
does for regular patients, and that is possibly the reason 
why some clinics are much better attended than others. 

We try never to disappoint our free clinic patients in 
the way of being late any more than we would our regular 
patients. They should not be kept waiting any longer 
than a regular patient. It resolves itself into this: What- 
ever you do, do well. If you do not care to do it well, do 
not do it at all. 

The mothers of children in the free climes are often 
much more alert and ask many more pertinent questions 
than do the mothers who pay well for their treatment. The 
poor class have been thrown around from one clinic to an- 
other until they are pretty well posted regarding certain con- 
ditions, and they are perfectly able to ask questions that 
will often puzzle you if you are not absolutely posted and 
on the alert. 

Here again the nurse comes in very handy in being of 



Office Attendants 261 

great assistance to the mothers who bring their children to 
the free clinic for attention. You may not think it, but 
there are people in every city where clinics are held, who will 
encourage children to go to the clinics just to try out the 
doctor and see what he can accomplish, and if a physician 
gets satisfactory results, they will go. I have seen this 
done many a time, and that is one reason why we pay such 
particular attention to all of our clinic cases. A physician 
with a large practice, well known in a city, is invariably 
watched by some one in every case he is treating, and soon- 
er or later you will hear directly or indirectly that you have 
made good or failed in some case that you thought no one 
had under observation. 



CHAPTER XXX 



ATTITUDE OF A 

PHYSICIAN TOWARD 

A PATIENT 






CHAPTER XXX. 

ATTITUDE OF A PHYSICIAN TOWARD A 
PATIENT 

The best known diagnostician in the New England 
States was called on a case a few years ago, one stormy 
night, and the husband of the patient, not having seen the 
famous doctor before, was not at all pleased with the first 
words uttered by the doctor, and ordered him to go home, 
saying that he would not have him treat a cat of his. 

Now, to my mind, it is not always a matter of person- 
ality, and it is impossible for any physician, no matter how 
high-standing in his profession, to satisfy patients, or even 
friends and relatives, at all times. 

One of the best diagnosticians in Canada is a little man 
who could walk under the arm of a well-developed man, and 
yet more people consult him in the course of year's time than 
any three or four other specialists put together. Appear- 
ance is not everything, though it goes a long way in some in- 
stances, and it is often from a peculiar standpoint that some 
physicians express themselves to their patients. 

Lou Fildes' painting, "The Doctor," which hangs in 
the majority of physicians' offices and is known the world 
over, represents the typical doctor of the Old School. In 
this day and age, the majority of physicians do not dress as 
they did in those days, nor consider it essentially ethical 
or necessarily high-type to wear a full beard. Some day 
a modern artist may paint in colors on a canvas the supposed- 
ly modern physician; but I dare say it would be much more 
difficult at the present time to give the people a picture of 
a typical physician than it was in those days when there 

—265— 



266 Practical Visions 

seemed to be certain characteristic features that made the 
doctor most distinctive in type, enabling the people almost 
invariably to point out a physician in any gathering. Some 
of the best surgeons at the preseut time could walk through 
a crowd or sit in an assembly hall, and it would be almost 
impossible for any one but a mind-reader or detective to 
decide who was a physician. 

We have some business men at the present who have 
the appearance of physicians, and who possibly have better 
judgment in dealing with men and women, than some phy- 
sicians have. A keen business head nowadays must be a 
psychologist; must be able to read people; and with a little 
extra training in the way of diagnosing, he might make as 
good a physician as some who are posing as specialists. 

Fifty percent of the success in healing ordinary cases 
depends on the first second of a doctor's meeting with a 
patient, especially if the patient be a woman. If it is an 
emergency case, it is quite different. The patient, in that 
instance, is glad to have relief of any kind, and she will have 
general confidence in whoever is brought; but in consulting 
a prominent physician, or diagnostician, the moment the 
doctor enters the home, or the patient enters the consulting 
room, he will be sized up and much of his success in handling 
the case will depend upon the result of the first impression. 
Conservatively speaking, fifty percent of success in handling 
the case will depend on the first impression. 

At the same time, whether the patient knows it or not, 
the physician is likewise summing up the patient, and we 
hope some day to bring out a book, which we have had in 
mind for years, that may interest the laity, in that it will 
give somewhat of an idea as to the amount of knowledge a 
physician may obtain by simply taking one glance at a pa- 
tient. There are physicians who could sit down and write 



Attitude Toward a Patient 267 

a three hundred page book on what they observed in a 
patient in ten seconds' time. Had we space in this book, 
we would write a chapter, just to indicate what we refer to. 

A physician is trained year in and year out to be a phys- 
ical detective. Every move that a patient makes means 
something to the physician. Every wink of the eyelid 
suggests certain nervous symptoms. Every facial expres- 
sion gives the physician a clue as to the condition of the cen- 
tral nervous system. The shaking of the hand indicates 
vasomotor tone, or lack of it. The feel of the skin on the 
hand also speaks a volume. 

So on and so forth we might outline what we wish to 
present some time; but we will confine the discussion in this 
chapter to the theme the title indicates. 

The first meeting of physician and patient is a peculiar 
proposition. We do not wish to discuss psychotherapy, 
psycho-analysis, or even phychic phenomena. Neither do 
we care to discuss possibilities in the way of suggestive thera- 
peutics, new thought, mental healing, or any other of the 
various propositions that are being discussed so much at 
the present time. 

We must appreciate the fact that is it practically a 
matter of the meeting of the positive and the negative, for 
the physician is or should be a great positive force, with 
full, complete, command and control of himself, in that he 
is usually too busy and knows too much to be sick, and, 
being well, he faces the patient, a weak, frail, sick, and nega- 
tive individual, and probably frightened besides. There- 
fore, the practitioner, coming into contact with the patient 
for the first time in this mental relationship, finds it axiom- 
atic, that fifty percent of his success depends upon the first 
second of mental contact. 

Following the order used in the greatest institutions, 



268 Practical Visions 

it is invariably better for some one in the doctor's office to 
interview the patient first, and a nurse is the best beginning 
that we know of. We will consider now a private physi- 
cian's office, and not a group clinic where a number of doc- 
tors make separate diagnostic records before the head phy- 
sician is consulted. 

In your own private office the nurse will be able to give 
the patient all necessary instructions, answer questions per- 
taining to treatment, and prepare her for the meeting with 
the doctor. The doctor enters in a quiet, unassuming man- 
ner, and becomes acquainted with the patient first, thus sav- 
ing his own energy, and the timidity on the part of the pa- 
tient will soon be overcome. If the case is a nervous type, 
the physician will make no headway unless he can secure 
the confidence of his patient. We refer particularly to 
women patients who are often of a nervous type, and all 
physicians have a great many of them. The patient must 
realize that the physician is master of the situation, well- 
posted in his work, and absolutely interested in the case. 
This idea held by the patient will inspire confidence. 

Osteopathic physicians should realize that the human 
being individually is not only an animated anatomy, or 
physical machine, but something beyond and above that — 
a soul. We may not understand what this peculiar principle 
is. We may not all agree, from a physiological standpoint; 
but there are many cases that come under our observation 
that must be treated partly at least by suggestion, or in some 
manner that will rectify worry and mental impressions that 
have disturbed the nervous equilibrium. Every physician 
should be sufficiently posted in psychotherapy and sugges- 
tion to enable him to use, discriminately and tactfully, the 
proper amount of suggestion, so that the patient may regain 
confidence and get hold of himself in a way that will elimin- 



Attitude Toward a Patient 269 

ate nervousness and dispel alarm that may be improperly 
held over symptoms and conditions. 

There is one other point we would like to emphasize. 
Ultimately, physicians must realize that all diseased condi- 
tions leave some scar on the mind or conscience of the pa- 
tient. If the physician is sufficiently posted in psycho- 
therapy to drop a word from day to day, while treating, 
that will develop the mental side as well as the physical, 
the patients will not complain, after the lesions have been 
corrected, that they do not yet feel just right physically. 

The mind must be healed as well. It may be from one 
standpoint, or it may be from another. The wise physician 
is the one who will sum up his patient's mental attitude, and 
deal with him from a standpoint that will appeal to him. 

Conclusion — Let each practitioner look upon his pro- 
fession as an exalted one, in that he not only heals through 
knowledge of the wonderful laws of the body, from a physi- 
cal standpoint, but that he fails in his duty to man when he 
does not present to his patient, by illustration or demonstra- 
tion, a higher level of life and an idealism that the patient 
must follow in order that he will be physically and mentally 
normal. 

After all lesions have been corrected, let the physician 
have a final interview, sit down and tell the patient some- 
thing like this: "Now that I have healed your body, it 
is principally your mind that will keep your body well," 
and pointedly tell the patient that unless he has, besides his 
trade or profession, some special hobby or avocation, of a 
relaxing and inspiring nature, he will be a patient forever, 
and you don't want that. 

There comes a time when a patient must depend upon 
his own lesources, in order to keep himself mentally rounded 
out, and we refer to the mental phase as one of nerve equi lib- 



270 Practical Visions 

rium, and the patient must feel eventually that he is more 
or less satisfied with his own conduct, reasonings, and atti- 
tude towards his fellow men. 

That physician will have accomplished most who best 
trains his patients to be mentally, as well as physically, 
normal. 

Joy in work is service to God and man! 

THE END 






LYMPHATICS 

APPLIED ANATOMY and TREATMENT 

By F. P. MILLARD and a Number of Other Osteopathic 
Specialists 

About 70 half tones, including specially designed drawings 
by Millard. Best enameled paper, clear type, cloth bound, gilt 
lettering. The cost of cuts in some single chapters amounts to 
more than $40.00. Dr. Evelyn Bush has a chapter on "The 
Value of Exercises on the Lymph Stream." (Twelve Illustra- 
tions.) Dr. Downing, a pioneer in lymphatics, has a chapter 
from the Orthopedic standpoint. Drs. Edwards, Reid, Deason, 
Collins, Ashley, Moore, Snyder, Bailey, Laughlin, and several 
others, have chapters on different phases of their work as ap- 
plied to lymphatics. This book is published under the auspices 
of the International Society for Lymphatic Research. 

Price, $6.00. Send orders to 

F. L. LINK, Kirksville, Missouri 



THE JOURNAL 

OF THE INTERNATIONAL SOCIETY 
FOR LYMPHATIC RESEARCH 

Edited by F. P. MILLARD, D. O., Toronto. 

Associate Editors: J. D. EDWARDS, M.D., D.O.; G. C. 

REID, M.D., D.O., and J. DEASON, M.S., D.O. 

A quarterly magazine, brimful of the latest and best research 
findings as to the place of the lymphatic system in the diagnosis 
and treatment of disease. Every number illustrated with origi- 
nal drawings by Millard. 

Subscription included with membership in the In- 
ternational Society for Lymphatic Research at $5.00. 
Price to non-members $2.00 a year. Address International 
Society for Lymphatic Research, Kirksville, Mo. 



INFANTILE PARALYSIS 

Written by Osteopathic Physicians. Edited by 
F. P. MILLARD, D. O. 

Dr. Florence Gair has two interesting chapters, illustrated 
with photographs, of cases that have been restored to normal by 
osteopathic methods. The book contains case reports from 
dozens of osteopathic physicians. It is written for the laity 
as well as for the osteopathic practician, and contains a mint of 
valuable information on infantile paralysis. It should b<* in 
every home, and certainly no osteopath should be without it. 

Bound in Cloth with Gold Title Stamped on Cover 

Splendidly Illustrated Throughout by One Hundred Cuts 

Fourteen Full-Page Plates — Two in Colors 

The book contains a comprehensive index which adds great- 
ly to its usefulness and value. 

COMMENTS ON BOOK 

I have just gone through your book on poliomyelitis. I 
want to compliment, you on writing such a good presentation 
of the subject. It is timely and strictly osteopathic. It shows 
the advance of therapeutics along this line. Your chapter on 
the causes and applied anatomy of the disease are worth far 
more than the price of the book. The chapters by the other 
writers are very encouraging. There is no osteopath in the 
world, but who ought to have this book in his library. — C. C. 
Reid, D. O., M. D. 

I just devoured it before retiring last night. It's fine, and 
I hope it gets a good sale. — E. Florence Gair, D. O. 

I am highly pleased with it. You are doing good work for 
the profession. — Geo. W. Goode, D. O. 

I enjoyed your book on infantile paralysis. I have shown 
it to all of my patients. Allow me to congratulate you. Your 
name will live in medical history as long as this old globe lasts. — 
James D. Edwards, D. O. 

Send $4.00 to F. L. LINK, Kirk 'lie, Missouri, at 
once and secure a copy of this valuable book. 

— H 233 83 n 













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